Infected Urachal Cyst Research Articles

A rare case of infected urachal cyst leading to intestinal obstruction in a 3-month-old boy with febrile urinary tract infection: Case report.

Urachal anomalies are rare and can present with various clinical manifestations. Urachal remnants, in particular, can be difficult to diagnose because of atypical symptoms at presentation. This study reports a case of intestinal obstruction in an infant secondary to an infected urachal cyst. A 3-month-old boy with a known febrile urinary tract infection developed acute abdominal distension. Abdominal ultrasound (US) and computed tomography (CT) revealed a nonspecific, ill-defined soft tissue density at the mid-abdomen, associated with intestinal obstruction. Emergency exploratory laparotomy was performed. The site of the obstruction was found to be at the mid-small bowel; the proximal small bowel was markedly distended, and the small bowel and sigmoid colon were adherent to urachal remnant. The urachal remnant was excised, and the peritoneal adhesions were lysed. The day after surgery, the patient was discharged without any complications. Intestinal obstruction is an exceedingly rare presentation of urachal remnants. This case highlights that urachal anomalies should be considered in the differential diagnosis in patients with intestinal obstruction and a concurrent febrile urinary tract infection.

Infected Urachal Cyst in Adult

Infected urachal cyst is one of urachal spectrum abnormalities. It usually presents in children because obliteration normally happened at early infancy. Rare case occurs in adult either can be small incidence or unrecognized symptoms until adulthood. Only small numbers of literature reported. The urachus is a tube extending from the anterior roof of the vesica urinaria to the umbilicus along the midline. The urachus is a vestigial fibromuscular structure located anterior to the fascia transversalis and posterior to the peritoneum. The presence of an embryonic urachal remnant can result in a variety of clinical complications. Due to the rarity of urachal residual disorders and the possibility of vague stomach or urinary symptoms, it is difficult to make a firm preoperative diagnosis. A 32-year-old female was referred to Saiful Anwar General Hospital after suffering abdominal pain for two months; the perineum felt the pain. There was a history of dysuria and nausea since the previous month, but no history of fever or change in bowel habits. Abdominal ultrasound showed an abscess at the anterior bladder and MRI showed an infected cyst mass in the suprapubic pointing to the left umbilical. Partial cystectomy and uterus biopsy were performed. The histopathologic result showed chronic inflammation tissue, and no malignancy was found. Misdiagnosis may lead to many complications such as progressive infection until malignancy therefore early detection of this case is important.

VERY RARE COMBINATION OF PATENT VITELLOINTESTINAL DUCT WITH PATENT URACHUS

Introduction - The vitelline duct is the embryological narrow channel connecting the yolk sac with the intestine. During the foetal life, vitelline duct tends to obliterates itself till to disappear. The partial failure of this obliteration can lead to the development of a duct, a ligament, or a diverticulum known as a Meckel's diverticulum. A Patent omphalomesenteric duct occurs because of the complete lack of vitelline duct.[3] The urachus is an embryological remnant of the allantois. Between the fourth and fth month of gestation, the foetal bladder tends to descend gradually and its apical portion creates the urachus. The urachus obliterates itself, becoming the median umbilical ligament. Its persistence after intrauterine life can manifest as urachal remnants. A patent urachus is because of complete lack of obliteration of urachus [1,3]. The incidence of these anomalies PU was 1-2 per 10000 while PVD is 1 in 5000 to 8000 deliveries [1,3,5]. The association of both anomalies is very rare [7]. Case discussion- A 12-years-old male presented with complaints of pain in abdomen, multiple episodes of vomiting. Patient was tachycardiac with tenderness in right iliac fossa with palpable lump with ultrasonography suggestive of perforated appendix with lump formation and was managed conservatively and asked for interval appendicectomy with CECT abdomen. CECT was suggestive of normal and compressible appendix with infected urachal cyst. But after 4weeks patient had similar complaints hence posted for emergency operation with McBurney's incision not by midline incision to avoid injury to urachal cyst. Intra operative ndings-1) patent Vitello intestinal duct 2) patent urachus 3)15cc pus discharge near umbilical end of urachus 4) normal appendix and small bowel. Resection of Vitello intestinal duct and urachus with ileoileal anastomosis done and specimen sent for histopathology which was suggestive of patent vitello intestinal duct with changes of gangrene. The Patent Vitello Conclusionintestinal duct with patent urachus is very rarely seen in combination and its diagnosis may be missed preoperatively and should be kept as a possibility in patients with patent urachus with or without infection

Infected urachal cyst in an adult, report of two observations.

IntroductionUrachus is an embryonic remnant that usually involutes before birth. Abnormal persistence of this structure gives embryologic malformation like an urachal cyst. Infection or malignancy degeneration can complicated it.Case presentationCase 1: We report 20 years old female patient consulted with acute abdominal pain. Clinical examination showed fever and infra-umbilical tender mass. The abdominal Computerized Tomography showed pelvic mass between umbilicus and bladder. The open laparotomy found infra-abdominal semi-solid mass. A complete resection was done and histological exam confirmed infected urachal cyst.Case 2: A 19 years old male patient presented with abdominal pain and fever. Physical examination found tenderness in lower abdomen. Biology revealed leukocytosis, and Ultrasonography found a heterogeneous infra-umbilical mass. Surgical exploration by mini-laparotomy found an abscess urachal cyst that is confirm by histological exam after complete resection.Clinical discussionUrachal cyst in adult patient is rare. Clinical symptoms without complications are insignificant. Because of malignancy risk, adult urachal cyst are managed by surgery.ConclusionInfection cyst is the most common complication of urachal cyst. Complete resection is recommended because of malignancy degeneration risk.

Infected Urachal Cyst Masquerading as Acute Appendicitis on Point-of-care Ultrasound.

CASE PRESENTATIONA seven-year-old male presented to the pediatric emergency department with one day of abdominal pain. His physical exam was significant for rebound, guarding, and tenderness in the right lower quadrant, and his labs demonstrated a leukocytosis. Both a point-of-care ultrasound and radiology-performed ultrasound were concerning for acute appendicitis with a periappendiceal abscess, but on emergent laparoscopy the patient was found to have an infected urachal cyst.DISCUSSIONInfected urachal remnants are a rare but important cause of pediatric abdominal pain. In this case, inflammation surrounding the patient’s midline urachal cyst triggered a serositis that involved the appendix and pulled the cyst to the right. This created a clinical and radiologic presentation similar to appendicitis. This atypical presentation of an already rare anomaly highlights the importance of maintaining a broad differential during the work-up of pediatric abdominal pain.

Laparoscopy Assisted Management of Urachal Anomalies In Children; A Relief for The Surgeon and the Patient?

Anomalies of the urachus constitute a challenge for the physcian and a source of anxiety for the parents. As the significance of the condition and borders between normal and abnormal are not clear, management is controversial. Although not universal, common indications for surgery are presence of symptoms (infection, pain etc) and fear of malignant transformation. Materials And Methods The children who underwent a laparoscopic surgery for a condition related to urachal remnants between 2007 and 2019 are enrolled in the study. Demographics of the patients, intraoperative complications and histological results were retrospectively evaluated and surgical procedure is described. Results A total 13 patients were included in the study. Seven patients had urachal cyst (53%),3 had urachal sinus (23%), 1 patent urachus (8%), 1 omphalomesenteric band remnant (8%) and could not be classified in 1 (8%). Three ports were employed in 6 patients, 4 ports in 4 and 1 port in 2 and 2 ports in 1.Peritoneal contamination could not be avoided in 1 patient with infected urachal cyst during the operation, but postoperative course was uneventful in this patient. Conclusion Although surgical excision is the most commonly recommended management modality for urachal remnants, both parents and physicians hesitate due to the mysterious nature and insufficient data about the long term consequences of the condition. Choosing the best incision is also an issue and physicians may regret for any of the incisions as they may be ‘too extensive’ or ‘insufficient’. Laparoscopic approach provides satisfactory identification of the condition, superior exposure and cosmesis, and at the worst scenario, a chance to select the most appropriate incision.

An infected urachal cyst presenting as repeated cystitis in a child.

An infected urachal cyst presenting as repeated cystitis in a child.

Urachus Pathology: Infected Urachal Cyst

The urachus is a fibrous residue of the allantois that disappears after birth. In some cases, it may persist, which is called urachus abnormalities. This persistence of the urachus is manifested by abdominal pain and can be signalled by complications, of which infection is the most common complication. Infection can be misunderstood and confused with other pathologies, especially when associated with abdominal pain. In our case, we report an observation of an infected urachal cyst, revealed by febrile abdominal pain and swelling.

A rare case of eosinophilic cystitis involving the inside and outside of the urinary bladder associated with an infected urachal cyst

BackgroundEosinophilic cystitis is a rare inflammatory disease of the bladder characterized by eosinophilic infiltration of the bladder wall. Most Eosinophilic cystitis cases present with mucosal lesions of the urinary bladder. We present a very rare case of large mass-forming eosinophilic cystitis, involving the inside and outside of the bladder associated with an infected urachal cyst.Case presentationA 59-year-old man presented with gross hematuria, fever, dysuria, and suprapubic pain. Computed tomography showed a heterogeneously enhancing mass that measured 7.6 cm × 4 cm located on the anterosuperior portion of the bladder with an internal fluid collection. Cystoscopy revealed a raspberry-like mass lesion on the bladder dome. Transurethral resection of the bladder was initially performed. The mass lesion protruding from inside the bladder was removed, and pus-like fluid was drained. The pathologic diagnosis was eosinophilic cystitis. Follow-up computed tomography showed a remnant mass outside the bladder and urachal cyst. To eliminate the remnant lesion, robot-assisted partial cystectomy was performed. The patient showed no evidence of recurrent disease on follow-up cystoscopy and computed tomography for up to 2 years.ConclusionsClinicians should consider the possibility of eosinophilic cystitis in patients who present with hematuria, fever, and suprapubic pain and have both intravesical and extravesical masses.

ИНФИЦИРОВАННАЯ КИСТА УРАХУСА У ВЗРОСЛОГО

Urachus is a tubular formation originating from the top of the urinary bladder and directed to the umbilicus between the peritoneum and the transverse fascia of the abdomen. In an embryo, it serves to divert primary urine to the amniotic fluid. In case, if obliteration of the duct does not occur until the birth, various pathological processes can develop in it. The most common abnomalies of urachus reported in adults are an infected urachal cyst and urachal carcinoma. These diagnoses are not always easy to make due to atypical symptoms of their manifestation and the rarity of these diseases - just two cases per 100,000 hospitalizations of adults. A 22-year-old man with a subcutaneous abscess and anexternal fistula located in theumbilical region with redness of the surrounding skin. 16 hours after dissection and drainaging of the abscess, the patient’s condition worsened, pain in the lower parts of the abdomen began, muscle tension of the anterior abdominal wall and inflammatory changes in blood tests were revealed. The patient was operated on for peritonitis. A two-chambered urachus cyst of the «hourglass» type, with the formation of a dense consistency calculus in one of the cavities, which perforated into the abdominal cavity This clinical case is of the great interest from the point of view of the atypical course and the treatment of a rather rare anomaly in adults. The publication will remind emergency medicine physicians about the possibility of infected urachus in patients with symptoms of acute abdomen.

Retro Umbilical Abscess Mimicking Infected Urachal Cyst: A Rare Presentation from Migratory Fish Bone Ingestion

Retro Umbilical Abscess Mimicking Infected Urachal Cyst: A Rare Presentation from Migratory Fish Bone Ingestion

Dysuria, Rebound Tenderness, and a Palpable Mass-A Ticking Time Bomb.

A 37-year-old male presented to the emergency department with the complaint of periumbilical abdominal pain, radiating to just above pubic symphysis. The patient reported that the pain was worse with urination and associated with chills and nausea. This case reports discusses the Emergency Department (ED) course and subsequent treatment of a patient found to have an infected urachal cyst, a previously asymptomatic embryological anomaly in an otherwise healthy middle-aged adult male. This is a crucial diagnosis to make in order to avoid the potential for significant morbidity and/or mortality, given the unlikely symptomatic source.

An Infected Urachal Cyst Mimicking a Lower Urinary Tract Infection in a Young Adult

Urachus is an embryologic remnant of allantois, which in adults presents as medial umbilical ligament connecting the dome of the bladder to the umbilicus. Defective obliteration of the urachus results in various urachal abnormalities. An infected urachal cyst is one of the urachal abnormalities, all of which are rare in adult life. The clinical presentation of an infected urachal cyst in adults is heterogeneous, and therefore, the diagnosis may be occasionally challenging. We present and discuss a case of a 25-year-old man with an infected urachal cyst, mimicking a lower urinary tract infection.

Infected Urachal Cyst in a Young Female: A Case Report

The urachus is a tubular structure that is patent during gestation. The lumen normallycloses at about the twelfth week of gestation and obliterates completely. Patenturachal anomalies are usually detected in childhood2,3. In adults they occur veryrarely and the presentation and diagnosis may be occasionally challenging. Wepresent and discuss the case of an infected urachal cyst found in a 25 year oldfemale. Bangladesh Journal of Urology, Vol. 22, No. 1, January 2019 p.100-102

Infected urachal cyst in a young adult: A case report

The urachal 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. Clinical presentation is non-specific; therefore, a high index of suspicion is required to make the diagnosis. When it is diagnosed, surgical excision is advised due to the risk of malignant transformation. We describe the case of a 26-year-old male who presented with a small swelling of the umbilicus and purulent umbilical discharge. The diagnosis of an infected urachal cyst was confirmed on ultrasonography abdomen and contrast-enhanced computed tomography abdomen. He was treated initially with broad-spectrum antibiotics and then by surgical excision of the cyst and fibrous tract. Histology of the excised specimen showed chronic inflammation with no evidence of malignancy. Post-operative recovery was uneventful.

Urachal cyst infection as a cause of acute abdomen: A case report and discussion about controversial issues of its management in children

Defects of the urachus obliteration may lead to urachal abnormalities such an urachal cyst, which tend to rest asymptomatic. We report a case of a four-old-year boy who referred a three-week history of abdominal pain, dysuria and fever. A hypogastric mass was observed at the exploration. The ultrasonography and the computed tomography were compatible with an infected urachal cyst. Intravenous antibiotic therapy was started, with an optimal response. Four months later, a chirurgical complete excision of the urachal cyst was performed. Among different congenital disorders of the urachus, urachal cysts and patent urachi are the most frequent. Urachal cysts may become infected, causing suprapubic pain, dysuria, fever and abdominal mass, as well as signs of peritonism. The main tool for diagnose these lesions is ultrasonography. They could potentially degenerate into adenocarcinoma in adults, which is rare but associated to bad prognosis. Urachal remnants have been classically managed surgically. However, an active surveillance of these lesions with a conservative treatment could be an alternative, since spontaneous resolution is more common than previously thought.

The Guilty Mother.

> The December 2017 issue of Pediatrics featured the first and second place articles from the First Annual SOPT Advocacy Essay Competition, which focused on the effects and management of toxic stress. The Editorial Board of the SOPT Monthly Feature is pleased to continue this discussion on toxic stress with the following article by Dr Paul E. George. In the article, he poignantly describes the numerous challenges faced by undocumented immigrants and advocates for several key solutions to mitigate the severe effects of toxic stress associated with immigration. > > Catherine Spaulding, MD, Editor, Pediatrics , SOPT Monthly Feature “ This patient is an adorable 5 y/o F with spina bifida, complicated by paraplegia, bilateral Grade 3 reflux, admitted with a urinary tract infection and infected urachal cyst, status post drain placement, currently on IV antibiotics. ” The sign out for Anayansi was perfect. This little girl with giant hazel eyes and curly, black hair, whose lack of English didn’t stop her from talking with anyone in her hospital room, certainly fit the “adorable” description. Yet Anayansi did not garner the most attention on rounds; rather, the gaze of the team members kept drifting toward her mother, or more specifically, toward the conspicuous ankle monitor and charger that confined her to the corner of the room while we discussed her daughter. “I wonder what she did?” whispered my coresident as we left. A simple question with a bitter answer. Anayansi’s mother was born outside of the United States. Knowing her daughter would not receive the medical care she needed in her home country, she left with her 2 young … Address correspondence to Paul E. George, MD, Baylor College of Medicine, Texas Children’s Hospital, 6621 Fannin St, Houston, TX 77054. E-mail: george.paul.e{at}gmail.com

An Infected Urachal Cyst with Disseminated Peritonitis Due to Hypermucoviscous Klebsiella pneumoniae: Report of a Case

An Infected Urachal Cyst with Disseminated Peritonitis Due to Hypermucoviscous Klebsiella pneumoniae: Report of a Case

To excise or not to excise infected urachal cysts: A case report and review of the literature

Abstract Urachal anomalies, and urachal cysts in particular, are common congenital anomalies that can remain asymptomatic throughout a lifetime or rarely cause life threatening illness if infected. We present a case of a complicated infected urachal cyst and review the literature on its work up and management, including the controversial issue of whether surgical management is always necessary for definitive treatment of this entity.

Computed tomography localization of the appendix in the pediatric population relative to the lumbar spine

Computed tomography (CT) is commonly used to evaluate suspected acute appendicitis. Although very effective, CT uses ionizing radiation, exposing patients to an increased risk of cancer. This study assessed the potential for decreasing the field of view of the CT (and therefore the dose to the patient) in the evaluation of suspected acute appendicitis in children. This study was a retrospective review of prospectively collected data from 212 consecutive patients who underwent CT for suspected acute appendicitis. The most superior aspect of the appendix with respect to vertebral bodies was recorded. Age, gender and diagnosis (negative, acute appendicitis or alternative diagnosis) were noted. The appendix was visualized in 190 of 212 subjects (89.6%). Overall, all visualized appendixes were located at or below the level of L1. Sixty-three of the subjects (29.7%) were diagnosed with acute appendicitis via CT imaging. All appendixes in patients with acute appendicitis were located at or below the level of the L3 vertebral body, predominating at the level of L5. Six subjects (3.1%) received alternative diagnoses, including pneumonia, pyelonephritis, small bowel obstruction and infected urachal cyst. There were no differences in appendix location with regard to diagnosis, gender, or age (P=0.664, 0.748 and 0.705, respectively). CT field of view may be decreased to the level of L1 or L3 superiorly, decreasing radiation dose without affecting the rate of appendix visualization.