Urachal-sigmoid fistula associated with diverticular disease

Abstract

Background: Urachal anomalies rarely present in adulthood. We report thesecond known case of urachal-sigmoid fistula associated with diverticulardisease.Method: We performed a case report and literature review. We searchedMEDLINE and PubMed using the search words “urachus,” “urachal fistula,”“sigmoid colon” and “diverticulosis.”Results: Our literature review revealed 1 previous report of urachal-sigmoidfistula associated with diverticular disease. We reviewed other publications withrespect to pathophysiology, diagnosis and management of urachal disease.Conclusion: Urachal disease that presents in an adult is usually the result of somecomplication of a urachal anomaly. Various modes of imaging may help confirmthe diagnosis, although CT sinography has been recommended and waskey in the present case. Management includes eradication of infection and, usually,surgical intervention.

A Sigmoid-Urachal-Cutaneous Fistula after Acute Diverticulitis

“…The urachal rest may become infected or ruptured and fistulize to the adjacent organs (2). As a consequence of the diverticulitis episode, the sigmoid colon or peridiverticular abscess may adhere to the patent urachus and develop a colourachal fistula with feculent umbilical drainage, pneumaturia, and fecaluria; the colourachal fistula is very rarely reported in the present literature (1)(2)(3)(4)(5)(6).…”

“…Only few cases of urachal-sigmoid fistulae have been reported (1). Most of these cases were without any obvious colonic pathology; our case is of one of the rarely reported sigmoid urachal cutaneous fistula associated with diverticulosis.…”

A colo-urachal-cutaneous fistula in an 88-year-old male

“…Two cases were associated with diverticular disease and in one no bowel pathology was found. 2,14 To our knowledge, no diverticulosis associated sigmoid-urachalcutaneous fistula has been described to this date. This case is unique not only because it is the first description of a diverticulosis associated sigmoid-urachal-cutaneous fistula but also because of the extremely old age of the patient.…”

“…1 Only six urachal-colonic fistulas have been described in literature. 2 We report the first case of an diverticulosis associated sigmoid-urachal-cutaneous cyst in an exceptionally old patient.…”

A Colourachal-Cutaneous Fistula: A Report of an Unusual Case

“…Colo-urachal fistulas can be secondary to diverticulitis pathology (4 cases; 50%) which irritates a preexisting urachal cyst [3, 4, 6–8]. For other cases, fistula is probably due to fistulisation into colon of an infected urachal cyst after a long irritation period.…”