Infected urachal sinus presenting as infraumbilical mass- A Case report and review of literature

Abstract

Urachal sinus is rare congenital urachal anomaly in adults develops from incomplete obliteration of fetal urachus. Usually incidental finding and remain asymptomatic unless a complication occurs. Complications includes infection, abscess, calculus, gas formation, intraperitoneal rupture, peritonitis and malignant transformation. High index of clinical suspicion is required when patient presents with pain abdomen, infraumbilical mass or umbilical discharge. Infected urachal sinus remains a diagnostic challenge due to its rare incidence and variable clinical presentations. We report a case in 37 year old female patient of infected urachal sinus presenting as infraumbilical mass, umbilical discharge and local tenderness. Two months back presented with fever, lower abdominal pain of unknown origin. Clinical suspicion of abdominal wall abscess or omphalitis were made. In our case ultrasonography and magnetic resonance imaging confirmed this rare entity. Brief discussion were made on clinical presentation, differential diagnosis, radiological findings and management options in order to prevent further complications, recurrence and malignant transformation.