Infected urachal cyst in an adult: a case report and review of the literature

Kingsley C Ekwueme,Nigel J Parr

doi:10.4076/1757-1626-2-6422

Kingsley C Ekwueme, Nigel J Parr

Open Access

https://doi.org/10.4076/1757-1626-2-6422

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Abstract

IntroductionUrachal cyst is one of a spectrum of urachal abnormalities most commonly found in children. They are very rarely seen in adults because the urachus is normally obliterated in early infancy.Case presentationWe describe a case of a 32 year old male Caucasian who presented with a tender, midline, infraumbilical mass and purulent umbilical discharge. Diagnosis of an infected urachal cyst was confirmed on magnetic resonance scan. He was treated initially with broad spectrum antibiotics in order to allow sepsis to resolve prior to surgical excision of the cyst and fibrous tract. Cystoscopy was performed intraoperatively to exclude sinus communication with the bladder. Histology of the excised specimen showed chronic inflammation with no evidence of malignancy. Postoperative recovery was uneventful.ConclusionUrachal abnormalities are rare in adults. Clinical presentation is non-specific; therefore, a high index of suspicion is required in order to make the diagnosis. When diagnosed, surgical excision is advised because of the risk of malignant transformation.

Highlights

Introduction: Urachal cyst is one of a spectrum of urachal abnormalities most commonly found in children
Case presentation: We describe a case of a 32 year old male Caucasian who presented with a tender, midline, infraumbilical mass and purulent umbilical discharge
We describe a case of urachal cyst presenting with a tender infraumbilical mass, purulent umbilical discharge and sepsis, in a previously fit and well man

Summary

Introduction

Urachal abnormalities result from incomplete regression of the foetal urachus. We describe a case of urachal cyst presenting with a tender infraumbilical mass, purulent umbilical discharge and sepsis, in a previously fit and well man. Cases Journal 2009, 2:6422 http://casesjournal.com/casesjournal/article/view/6422 with constant lower abdominal pain, chills and rigors. He gave no history of nausea, vomiting or change in bowel habit. He had completed a course of antibiotics prescribed by his General Practitioner with little relief. An MRI scan, confirmed the diagnosis of UC communicating proximally with the umbilicus (Figure 1). A repeat MRI scan was subsequently performed with a full bladder, to exclude any distal communication. Cystoscopy and excision of the infected urachal cyst were performed simultaneously.

Discussion

Conclusion

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