DOI: http://dx.doi.org/10.18203/2349-2902.isj20213633

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

Akula Nynasindhu, Swetana Palavalasa

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.


Keywords


Umbilical abscess, Urachal sinus, Urachal cyst

Full Text:

PDF

References


Gleason JM, Bowlin PR, Bagli DJ, Lorenzo AJ, Hassouna T, Koyle MA, et al. A comprehensive review of pediatric urachal anomalies and predictive analysis for adult urachal adenocarcinoma. J Urol. 2015;193(2):632-6.

Venkat B, Kale S, Reddy SKBV, Govindaiah G, Mohammed IG, Panchal N. Look Before You Leap: Urachal Mass in Adults. World J Oncol. 2017;8(1):20-4.

Jayakumar S, Darlington D. Acute Presentation of Urachal Cyst: A Case Report. Cureus. 2020;12(5):8220.

Choi YJ, Kim JM, Ahn SY, Oh JT, Han SW, Lee JS. Urachal anomalies in children: a single center experience. Yonsei Med J. 2006;47(6):782-6.

Lee SH, Lee HI, Shin DG. Urachal cyst presenting with huge abscess formation in adults. J Korean Surg Soc. 2012;83(4):254-7.

Ekwueme KC, Parr NJ. Infected urachal cyst in an adult: a case report and review of the literature. Cases J. 2009;2:6422.

Cappele O, Sibert L, Descargues J, Delmas V, Grise P. A study of the anatomic features of the duct of the urachus. Surg Radiol Anat. 2001;23(4):229-35.

Mazzucchelli R, Scarpelli M, Montironi R. Mucinous adenocarcinoma with superficial stromal invasion and villous adenoma of urachal remnants: a case report. J Clin Pathol. 2003;56(6):465-7.

Villavicencio C, Adam SZ, Nikolaidis P, Yaghmai V, Miller FH. Imaging of the Urachus: Anomalies, Complications, and Mimics. Radiographics. 2016;36(7):2049-63.

Lee SH, Lee HI, Shin DG. Urachal cyst presenting with huge abscess formation in adults. J Korean Surg Soc. 2012;83(4):254-7.

Ash A, Gujral R, Raio C. Infected urachal cyst initially misdiagnosed as an incarcerated umbilical hernia. J Emerg Med. 2012;42(2):171-3.

Almas T, Khan MK, Fatima M, Nadeem F, Murad MF. Urachal Sinus Complicated by an Umbilical Abscess. Cureus. 2020;12(8):9527.