Chronic umbilical abscess secondary to a patent urachus in a 30 years male: a case report

Abstract

Urachus is epithelialized, fibromuscular remnant part connecting urinary bladder with umbilicus. Urachal anomalies present and progress differently in paediatric and adult population. They remain largely asymptomatic until infected. Clinical presentation may vary from simple discharge from umbilicus to intrabdominal abscess and peritonitis. We present a case of urachal sinus presenting as recurrent umbilical abscess. 30 years male presented with complaints of umbilical mass with pus discharge. He was evaluated clinically and radiologically. Ultrasound revealed a localized collection near umbilicus whereas CT scan revealed connection of that collection to a fibrous strand like structure approximately 10 cm extending from umbilicus to urinary bladder. An open exploration was done under regional anaesthesia and 20 ml of abscess drained with excision of tract by ligating near the bladder end. Local debridement was done near the umbilical area. Wound closed in layers. Post-op period was uneventful without any recurrence. urachal anamolies need a high index of suspicion in adults to intervene early and get better outcomes with less morbidity.