Infected Urachal Cyst Initially Misdiagnosed as an Incarcerated Umbilical Hernia

Ash, Adam; Gujral, Rashmeet; Raio, Christopher

doi:10.1016/j.jemermed.2011.05.046

Cited by 21 publications

(12 citation statements)

References 12 publications

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“…A partial or total defect of obliteration of the urachus channel after the fifth month of gestation can be the origin of urachal abnormalities. The first description was in 1550 by Cabriolus [1] and later a few cases of infected urachal remnants in adulthood were reported in the literature [2-5]. This entity is usually discovered in childhood, but a late onset in adulthood is always possible.…”

Section: Introductionmentioning

confidence: 99%

Abscess of urachal remnants presenting with acute abdomen: a case series

et al. 2012

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IntroductionUrachal diseases are rare and may develop from a congenital anomaly in which a persistent or partial reopening of the fetal communication between the bladder and the umbilicus persists. The most frequently reported urachal anomalies in adults are infected urachal cyst and urachal carcinoma. The diagnosis of this entity is not always easy because of the rarity of these diseases and the atypical symptoms at presentation. Imaging techniques, such as ultrasonography and computed tomography have a significant role in recognizing the presence of urachus-derived lesions.Cases presentationsCase presentation 1: A 25-year-old Arab-Berber man presented with a 10-day history of progressive lower abdominal pain accompanied by fever, vomiting, and low urinary tract symptoms to our emergency department. Laboratory data revealed leucocytosis. The diagnosis of an acute peritonitis was made initially. Abdominal ultrasonography revealed a hypoechoic tract from the umbilicus to the abdominal wall, and the diagnosis was rectified (infected urachal remnants). The patient was initially treated with intravenous antibiotics in combination with a percutaneous drainage. Afterwards an extraperitoneal excision of the urachal remnant including a cuff of bladder was performed. The histological analysis did not reveal a tumor of the urachal remnant. Follow-up examinations a few months later showed no abnormality.Case presentation 2: A 35-year-old Arab-Berber man, without prior medical history with one week of abdominal pain, nausea and vomiting, associated with fever but without lower urinary tract symptoms visited our emergency department. Laboratory data revealed leucocytosis. Abdominal ultrasonography was not conclusive. Computed tomography of the abdomen was the key to the investigation and the diagnosis of an abscess of urachal remnants was made. The patient underwent the same choice of medical-surgical treatment as previously described for case one, with a good follow-up result.Case presentation 3: A 22-year-old Arab-Berber man, with no relevant past medical history, presented to our emergency department because of suspected acute surgical abdomen. Physical examination revealed umbilical discharge with erythema and a tender umbilical mass. Abdominal ultrasonography and computed tomography scan confirmed the diagnosis of infected urachal sinus. Initial management was intravenous antibiotics associated with a percutaneous drainage with a good post-operative result, but a few days later, he was readmitted with the same complaint and the decision was made for surgical treatment consisting of excision of the infected urachal sinus. The clinical course was uneventful. Histological examination did not reveal any signs of malignancy.ConclusionsWe describe our clinical observations and an analysis of the existing literature to present the various clinical, radiological, pathological and therapeutic aspects of an abscess of urachal remnants. To the best of our knowledge, this manuscript is an original case report because this atypical p...

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Section: Introductionmentioning

confidence: 99%

Abscess of urachal remnants presenting with acute abdomen: a case series

et al. 2012

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“…at Few cases of infected urachal remnants in adulthood were reported in the literature [2], [3] . In the umbilical-urachus sinus, the urachus obliterates at the bladder level but remains open at the umbilical site, causing a continuously draining sinus.…”

Section: Discussionmentioning

confidence: 99%

Umbilical-Urachus Sinus A variant of Patent Urachus Presentation With Management in Adults- A single Center Experience

Das¹

2017

JMSCR

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“…A preliminary diagnosis of umbilical hernia was made. Surgical evaluation confirmed the presence of urachal cyst [3]. Intraperitoneal disease processes can be challenging to distinguish as well.…”

Section: Discussionmentioning

confidence: 99%

Urachal Cyst Causing Small Bowel Obstruction in an Adult with a Virgin Abdomen

O’Leary

Ashman

Plurad

et al. 2016

Case Reports in Surgery

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Introduction. A patent urachus is a rare congenital or acquired pathology, which can lead to complications later in life. We describe a case of urachal cystitis as the etiology of small bowel obstruction in an adult without prior intra-abdominal surgery. Case Report. A 64-year-old male presented to the acute care surgery team with a 5-day history of right lower quadrant abdominal pain, distention, nausea, and vomiting. He had a two-month history of urinary retention and his past medical history was significant for benign prostate hyperplasia. On exam, he had evidence of small bowel obstruction. Computed tomography revealed high-grade small bowel obstruction secondary to presumed ruptured appendicitis. In the operating room, an infected urachal cyst was identified with adhesions to the proximal ileum. After lysis of adhesions and resection of the cyst, the patient was subsequently discharged without further issues. Conclusion. Although rare, urachal pathology should be considered in the differential diagnosis when evaluating a patient with small bowel obstruction without prior intraabdominal surgery, hernia, or malignancy.

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Infected Urachal Cyst Initially Misdiagnosed as an Incarcerated Umbilical Hernia

Cited by 21 publications

References 12 publications

Abscess of urachal remnants presenting with acute abdomen: a case series

Abscess of urachal remnants presenting with acute abdomen: a case series

Umbilical-Urachus Sinus A variant of Patent Urachus Presentation With Management in Adults- A single Center Experience

Urachal Cyst Causing Small Bowel Obstruction in an Adult with a Virgin Abdomen

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