Infected Urachal Cyst Research Articles

Kyste De L’ouraque Infecte : A Propos De Trois Cas Cliniques Au Chu De Parakou Au Benin

Bacground: The urachus is a fibrous remnant of the allantois. That connects the bladder dome to the anterior abdominal wall. After birth it is obliterated in general. In some cases it may persist as cyst , fistula , sinus or diverticulum. This persistence of the urachus often is signaled by a complication. Infection is the most common complication and the most dangerous is his degeneration. The infection can be misunderstood and confused with other pathologies of the navel. Methods: Our study reports three clinical cases of infected urachal cyst. Result: these report cases illustrate the need to think of this diagnosis before the painful of the navel and abdomen. The ultrasound examination can help for the diagnosis.

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

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.

Rupture of an infected urachal cyst

Rupture of an infected urachal cyst

Infected Urachal Cyst Following Laparoscopic Cholecystectomy

Infected Urachal Cyst Following Laparoscopic Cholecystectomy

An Infected Urachal Cyst in an Adult Woman.

The urachus is an embryologic remnant which degenerates after the birth. Defective obliteration of the urachus leads to urachal abnormalities. An infected urachal cyst is one of the urachal abnormalities and this pathology is rare in adult women. We report a case of 33-year-old woman with pelvic pain and dysuria who was diagnosed with infected urachal cyst. Infected urachal cyst is a rare pathology in adult women and this pathology should be considered in the differential diagnosis of acute abdomen.

Intestinal obstruction caused by a Meckel’s diverticulum adherent to an infected urachal cyst

Urachal remnant diseases are rare and frequently misdiagnosed, as the clinical presentation is similar to more common causes of intra-abdominal and pelvic disease. We report the rare case of a 1½-year-old boy with small-bowel obstruction caused by an adhesion band between a Meckel’s diverticulum and

English

An infected urachal cyst is one among the spectrum of presentations of urachal pathology, which are rare in adulthood. It occurs in a 2: 1 male to female ratio with an incidence of about 2% in adults. Patients with infected urachal cysts can present with a wide range of symptoms, most commonly abdominal pain, fever, umbilical discharge and the feeling of a midline mass Treatment is initiated with intravenous antibiotics followed by complete excision of the umbilicovesical tract including a cuff of bladder.

Laparoscopic treatment of symptomatic urachal remnants in children.

To evaluate laparoscopic treatment of symptomatic urachal remnants in children, the authors review their experience analyzing different approaches and results obtained in a 8-year period. From July 2005 to September 2013, 12 children underwent 13 interventions for treatment of symptomatic urachal remnants. In four patients, the technique was a laparoscopic-assisted removal of the remnant, in two patients, a laparoscopic-assisted drainage of an urachal abscess, and in seven patients, a laparoscopic excision of the remnant. One patient underwent a double intervention-laparoscopic drainage of an infected urachal remnant and its delayed laparoscopic excision. The laparoscopic-assisted removal of the urachal remnant was performed in two cases of infected urachal sinus, in one case of symptomatic sinus, and in one cases of infected urachal cyst. The laparoscopic-assisted drainage of urachal abscesses was performed in two patients: In one patient, the abscess was because of an infected sinus while in the other patient, the abscess was caused by an infected cyst. Of the seven patients treated with pure laparoscopic technique, one had a symptomatic sinus, another had an association between a symptomatic urachal sinus and an urachal cyst, and five patients had a symptomatic urachal cyst. In all cases, intraoperative or postoperative complications and recurrences did not occur, and the cosmetic results were good. Follow-up ranged from 6 months to 8 years and 8 months. Laparoscopic surgery for symptomatic urachal remnants is safe and reliable in cases of drainage of urachal abscess and in cases of excision of the remnant. Laparoscopy allows a radical excision of the remnants with all the advantages of this procedure. In case of conversion, laparoscopic-assisted technique with minimal incision could be a good alternative to open surgery.

V3-13 ENTIRELY MINIMALLY-INVASIVE MANAGEMENT OF AN INFECTED URACHAL CYST IN THE PEDIATRIC PATIENT

You have accessJournal of UrologyPediatrics1 Apr 2014V3-13 ENTIRELY MINIMALLY-INVASIVE MANAGEMENT OF AN INFECTED URACHAL CYST IN THE PEDIATRIC PATIENT Christopher Jaeger and Candace Granberg Christopher JaegerChristopher Jaeger More articles by this author and Candace GranbergCandace Granberg More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.1314AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Urachal cysts are the most common urachal anomaly in the pediatric patient population. Minimally-invasive approaches have become increasingly prevalent in management. We present an approach to entirely minimally-invasive management of a case of an infected urachal cyst utilizing percutaneous drainage and subsequent robot-assisted laparoscopic cyst excision. METHODS After initial ultrasound-guided percutaneous drain placement and culture-specific antibiotics, an adolescent male underwent delayed robot-assisted urachal cyst excision and partial cystectomy for an infected urachal cyst. The steps of this approach are demonstrated in this video, including (1) ultrasound-guided percutaneous drain placement; (2) placement of robotic ports; (3) identification of anatomic landmarks; (4) dissection of the urachal cyst and bladder from the anterior abdominal wall; (5) dissection of the cyst from the bladder; (6) removal of cyst with small cystotomy; (7) bladder closure in two layers; and (8) interrogation of closure with bladder distension. No perivesical drain was left. RESULTS The patient was discharged on postoperative day 1. A Foley catheter was left indwelling for three days and removed without need for cystogram. There were no complications and incisions were hidden within the umbilicus and at the level of the Pfannenstiel line, rendering the incisions non-visible when the patient wears a bathing suit. CONCLUSIONS Entirely minimally-invasive management of the pediatric infected urachal cyst including percutaneous drain placement and subsequent delayed robot-assisted laparoscopic urachal cyst excision with bladder cuff removal is simple, safe, and offers excellent cosmesis. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e425 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Christopher Jaeger More articles by this author Candace Granberg More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Clinical considerations, management and treatment of fever of unknown origin caused by urachal cyst: a case report

IntroductionUrachal cysts are rare congenital anomalies that often prompt referral to the paediatric general surgeon because of their associated complications such as infection, abdominal pain and the young age at presentation. In this report we describe a rare case of fever of unknown origin caused by an urachal cyst which was successfully treated with incision and drainage only. Since the first description of urachal anomalies by Cabriolus in 1550, few cases have been reported and, until now, only one case of infected urachal cyst presenting as fever of unknown origin has been described in the literature. Moreover, the spontaneous resolution of an urachal cyst without excision is extremely rare.Case presentationWe report our experience in the management and treatment of an infected urachal cyst that occurred in a 12-year-old Caucasian girl who presented to our Department of Paediatric Surgery with a 30-day history of evening fever. The urachal cyst was treated only with incision and drainage through a minimally invasive laparoscopic approach.ConclusionsThe incision and drainage of an infected urachal cyst is a simple and safe procedure. It assures a complete recovery and avoids potential surgical complications related to the total excision of the urachal cyst. This report may provide important clues regarding the management of this rare anomaly and we emphasise the importance for paediatricians, who should consider the possibility that a fever of unknown origin can be caused by an urachal cyst, and for surgeons and urologists, because it suggests that conservative treatment of this rare anomaly should be considered when possible.

Urachal Abscess Clinically Mimicking a Malignancy

Patent urachus accounts for up to 50% of cases in children, usually diagnosed in the neonatal period and due to the reflux from superior side of the bladder. In 30% of cases it may be associated to posterior urethral valves and urethral atresia [5]. In about 30% of cases an urachal cyst is present, consisting of a cystic cavity of the median umbilical ligament, closed off in its umbilical and vesical ends. An infected urachal cyst is the most usual presentation in the adult [2,6,7]. In the urachal sinus, presenting in up to 15% of cases, the apical segment of the urachus remains open and communicates with the umbilicus [8]. A vesicourachal diverticulum is more uncommon (3-5% of cases), which is an incomplete obliteration of the inferior portion of the median umbilical ligament that communicates with the vesical end [9,10]. In most cases these abnormalities are asymptomatic, usually giving off signs when infection befalls due to their remainders becoming overt [11]. The biggest problem with this kind of pathology is its atypical presentation, mimicking different signs and symptoms of seemingly usual urological problems, due to their close relation to neighboring structures, especially the bladder. Because of this and of the diagnostic tests findings, many times these abnormalities fall into the spectrum of urological cancer [12]. Urachal infection usually presents as pain, redness, warmth and purulent exudate, sometimes with clinical and analytical signs of systemic dissemination. The route of infection may be lymphatic, hematogenous or vesical. Thus, the choice of a specific antibiotic may be difficult due to the diversity of involved germs. The site of secretion may vary according to the level and degree of overture of the urachal lumen: the umbilicus in a urachal sinus; the bladder in a vesicourachal diverticulum; or both in a patent urachus. Intra-peritoneal rupture may be a serious complication due to the risk of peritonitis [13-15]. Imagiology demonstrate the complexity of this kind of pathology, because they may not allow for a clear diagnosis, showing solid and cystic components, and not able of distinguishing malignant

An unusual presentation of infected urachal cyst in an adult

Introduction: Urachus, median umbilical ligament, is normally obliterated in early infancy. so being remnant, is uncommon in adults. Delay in diagnosis and management can present with complications like drainage from umbilicus, severe abdominal infection, cyst with stone formation, fistula to urinary bladder, peritonitis, lump abdomen or carcinoma. Diagnosis remains challenging due to the rarity of this lesion and the non-specific nature of its symptomatology. case report: We report a case of a 35-year-old female presenting with umbilical sepsis with abdominal (suprapubic) pain. Investigations and laparotomy lead us to a confirmative diagnosis of infected urachal cyst. conclusion: Urachal anomalies are rare in adults. Presentation is atypical therefore a high index of suspicion is required in order to achieve a diagnosis. complete surgical excision is the treatment of choice due to the risk of malignant transformation.

An infected urachal cyst presenting as an acute abdomen – A case report

INTRODUCTIONAn infected urachal cyst is one of a spectrum of presentations of urachal pathology, all of which are rare in adulthood. PRESENTATION OF CASEWe report the case of a 45-year-old obese Russian lady who presented with a 2-week history of suprapubic pain radiating to the right iliac fossa. Although previously fit and well, she had a history of 17 miscarriages. Both USS and CT suggested a complicated inflammatory mass in the lower abdomen. Ultimately the diagnosis was made by laparotomy, which revealed an abscess of an urachal cyst. The infected cyst and bladder dome were excised. The patient made a good recovery with an uneventful follow up. DISCUSSIONUrachal cysts are the commonest type of urachal anomaly. Infection is the usual mode of presentation amongst adult cases otherwise the condition usually remains asymptomatic. An infected urachal cyst is an important diagnosis to make as complications include sepsis, fistula formation, and rupture leading to peritonitis. Treatment is by complete excision, however, techniques have been debated. CONCLUSIONThis is a rare but important diagnosis however we recommend that in patients with atypical histories, it should be included in the differential diagnosis.

Unique Presentation of Urachal Cyst Disease: Incidental Finding to Complicated Infection

Urachal remnant disease is uncommon in adults and can present with symptoms ranging from drainage near the umbilicus to a severe abdominal infection. Most cases are referred for treatment once diagnosed either clinically or radiographically with ultrasound or computerized tomography. We present a unique case of an infected urachal cyst visualized on a series of CT scans in an adult patient with abdominal pain over a period of years.

Laparoscopic Management of Complicated Urachal Remnants

Managing persistent and symptomatic urachal anomalies requires wide surgical excision of all anomalous tissue with a cuff of bladder tissue via the open approach. We report 7 cases with complete laparoscopic removal of symptomatic urachal remnants with or without a cuff of bladder tissue. We expected that this technique would be less invasive and have lower morbidity. We report on the feasibility of this approach, including efficacy and outcomes. Eight patients with a mean age of 36.5 years who had symptomatic urachal diseases underwent laparoscopic excision between July 2004 and July 2012. With the use of four ports, the urachal remnant was dissected transperitoneally and then removed via the umbilicus port. The clinical results of laparoscopic urachal remnant excision as a minimally invasive surgery, the perioperative records, and pathologic results were evaluated. There were no intraoperative or postoperative complications. Mean surgery time was 2.7 hours. Mean hospital stay was 14.6 days. The patients with bladder cuff resection had a long admission and Foley catheterization period (mean, 14.4 and 11 days). Pathological evaluations were 6 cases of infected urachal cysts, 1 case of infected urachal sinus, and 1 case of urachal adenocarcinoma. We found no postoperative complications including any symptom recurrence or voiding difficulty during a mean follow-up of 46.3 months. The perioperative surgical outcomes achieved infection control and symptomatic relief and additionally good cosmesis. Complete laparoscopic removal of symptomatic urachal remnants with or without a cuff of bladder tissue seems to be a safe, effective, and better cosmetic alternative with the advantages of a minimally invasive approach.

Infected urachal cyst secondary to a Crohn's enterourachal fistula

Enterourachal fistulas are exceedingly rare in Crohn's patients. We report a case of a presumed enterourachal fistula that led to an infected urachal cyst. Preoperative medical treatment obliterated the fistula and avoided the need to resect bowel at the time of operation. We recommend consideration of this diagnosis in a Crohn's patient with a midline abdominal mass.

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

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 presentation is rarely reported in the literature and only a few cases have been described.

Infected urachal cyst mimicking incarcerated umbilical hernia: A case report

Infected urachal cyst mimicking incarcerated umbilical hernia: A case report

An infected urachal cyst—a rare diagnosis in a child with acute abdominal pain

A 2-year-old girl who presented with acute abdominal pain and spiking fever was diagnosed with an infected urachal cyst. Ultrasonography aided the diagnosis and the urachal remnant was removed successfully through a single laparoscopic procedure. Treatment is through removal of the complete structure, to prevent malignant degeneration in adulthood. Urachal cysts may cause abdominal complaints when infected. Although rare, they should be added to the differential diagnosis of acute abdominal pain in the paediatric patient, as this case illustrates.

Infected Urachal Cyst Initially Misdiagnosed as an Incarcerated Umbilical Hernia

BackgroundUrachal abnormalities are a rare cause of lower abdominal pain. They are often initially mistaken for more common causes of lower abdominal pain, and the diagnosis is usually made during evaluation for one of these more common conditions. Case ReportWe report a case of a painful periumbilical mass ultimately diagnosed as an infected urachal cyst. Although the cyst was evident sonographically, it was misidentified as an umbilical hernia, and the correct diagnosis was not made until the patient underwent computed tomography of the abdomen and pelvis before surgery. ConclusionEmergency physicians should consider urachal disease in patients presenting with lower abdominal pain and should also be familiar with both the clinical and radiologic findings characteristic of this disease.