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Journal of Medical Case Reports Mar 2014Urachal cysts are rare congenital anomalies that often prompt referral to the paediatric general surgeon because of their associated complications such as infection,...
INTRODUCTION
Urachal 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 PRESENTATION
We 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.
CONCLUSIONS
The 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.
PubMed: 24661549
DOI: 10.1186/1752-1947-8-106 -
Anales Del Sistema Sanitario de Navarra Dec 2022Among the causes of acute surgical abdomen, infection of a urachal remnant may go unnoticed despite routine complementary studies. We present three cases in boys aged...
Among the causes of acute surgical abdomen, infection of a urachal remnant may go unnoticed despite routine complementary studies. We present three cases in boys aged 11, 6, and 4 years who were brought to the emergency department for right iliac fossa pain, fever, and urinary symptoms. Examination and complementary tests results were compatible with acute complicated appendicitis and were sent to surgery. While in the operating room, appendicitis was excluded and inflammatory changes suggestive of infection of the urachal remnant were documented. Complications of urachal remnants should be considered in the differential diagnosis of acute surgical abdomen, since advanced infection of the urachus may be a cause of confusion. A more accurate presumptive diagnosis can change the therapeutic/surgical approach and follow-up.
Topics: Male; Humans; Abdomen, Acute; Urachal Cyst; Appendicitis; Urachus; Diagnosis, Differential
PubMed: 36576388
DOI: 10.23938/ASSN.1026 -
Journal of Surgical Case Reports Jul 2019A urachus is a vestigial tubular structure that connects the urinary bladder to the allantois during early embryonic development. Urachal remnants are classified as...
A urachus is a vestigial tubular structure that connects the urinary bladder to the allantois during early embryonic development. Urachal remnants are classified as patent urachus, urachal sinus, urachal cyst, and urachal diverticulum. Ten patients with urachal remnants underwent surgery at our institution between 2015 and 2019. Six patients had a urachal sinus, and four had a urachal diverticulum. Two patients with urachal sinus underwent excision of the urachal remnant, from the umbilicus to the urinary bladder, using an umbilical approach. The other four patients with urachal sinus underwent laparoscopic surgery with excision of the urachal remnant, from the umbilicus to the urinary bladder. All patients with urachal diverticulum underwent open excision of the diverticulum through a Pfannenstiel incision. Pathologic examination of all urachal remnants showed no evidence of neoplasm and complete excision. All patients had an uneventful postoperative course and are doing well.
PubMed: 31384429
DOI: 10.1093/jscr/rjz222 -
BMC Pediatrics Mar 2023A urachal cyst has a rare incidence that has been reported as 1/5,000 live birth.
BACKGROUND
A urachal cyst has a rare incidence that has been reported as 1/5,000 live birth.
CASE PRESENTATION
We report two patients with a complicated urachal cyst, a 5-year-old female who presented to the emergency department with severe abdominal pain and a 3-year-old female presenting with abdominal pain and constipation. Upon laparoscopic exploration both patients had complicated urachal cysts which were adherent to the urinary bladder.
CONCLUSION
Complicated urachal cysts can present with acute abdominal pain.
Topics: Female; Humans; Child; Child, Preschool; Urachal Cyst; Abdominal Pain; Abdomen, Acute; Laparoscopy; Emergency Service, Hospital
PubMed: 37004016
DOI: 10.1186/s12887-023-03962-x -
Journal of General Internal Medicine Mar 2017
Topics: Abdominal Pain; Abscess; Administration, Intravenous; Adult; Anti-Bacterial Agents; Drainage; Humans; Male; Urachal Cyst
PubMed: 27393484
DOI: 10.1007/s11606-016-3804-1 -
Chonnam Medical Journal Apr 2013Managing persistent and symptomatic urachal anomalies requires wide surgical excision of all anomalous tissue with a cuff of bladder tissue via the open approach. We...
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.
PubMed: 23678477
DOI: 10.4068/cmj.2013.49.1.43 -
Hinyokika Kiyo. Acta Urologica Japonica Jan 1992A case of vitello intestinal cyst was reported. A 16-month-old girl was referred to our clinic with a complaint of a cystic mass in the region of the navel. With a... (Review)
Review
A case of vitello intestinal cyst was reported. A 16-month-old girl was referred to our clinic with a complaint of a cystic mass in the region of the navel. With a diagnosis of urachal cyst, resection of the cyst was performed. Histopathologically, the cyst wall consisted of fibrous and fat tissue, and a small polypoid tumor which was found on the inner surface of the cyst was covered by intestinal epithelia. Pancreatic and gastric mucosal elements were observed in the submucosal layer. The histopathological diagnosis was vitello intestinal cyst. Serum amylase level elevated preoperatively normalized after removal of the cyst. We collected 11 cases of vitello intestinal cyst reported in Japan including the present case. Ectopic pancreatic tissue is considered a characteristic of vitello intestinal cyst and that serum or fluid amylase level may be useful for differential diagnosis of the disease.
Topics: Amylases; Choristoma; Female; Gastric Mucosa; Humans; Infant; Intestinal Neoplasms; Pancreas; Urachal Cyst; Vitelline Duct
PubMed: 1372143
DOI: No ID Found -
Medicine Jun 2018The traditional surgical approach for removing a symptomatic urachal remnant is via a lower midline laparotomy and infraumbilical incision or a laparoscopic approach... (Observational Study)
Observational Study
The traditional surgical approach for removing a symptomatic urachal remnant is via a lower midline laparotomy and infraumbilical incision or a laparoscopic approach with umbilicoplasty. We reviewed our experience with umbilicus-sparing laparoscopic urachal remnant excision in a single-center study and evaluated its efficacy versus open approach (OA). This study was a retrospective study. Between March 2012 and September 2016, 32 consecutive patients with symptomatic urachal remnants underwent the umbilicus-sparing laparoscopic approach (USLA) (n = 17) or OA (n = 15). The efficacy, recovery, and long-term outcomes were reviewed. Our Results showed that the clinical characteristics of the patients in each group, such as age, gender, body mass index (BMI), and disease type, had no significant differences (P > .05). No significant difference was found in the surgical procedure times (76.1 ± 15.4 vs 69.2 ± 13.9 minutes, P = .189) and intraoperative blood loss (29.4 ± 13.3 vs 32.2 ± 12.9 mL, P = .543) between the USLA groups and OA groups. However, the mean postoperative hospital stay (patients with bladder cuff excision: 4.1 ± 1.8 vs 6.1 ± 1.4 days, P = .040 and patients without bladder cuff excision: 1.8 ± 0.5 vs 3.6 ± 0.8 days, P < .001) and the time of full recovery (11.2 ± 1.9 vs 15.6 ± 3.1 days, P < .001), the USLA group were both significantly shorter than that of the OA group. No infected recurrence and malignant transformation had occurred at a mean follow-up of 32.4 ± 8.1 and 34.1 ± 8.8 months in USLA group and OA group, respectively. In conclusion, to minimize the morbidity of radical excision, umbilicus-sparing management of benign urachal remnants in adults is a safe and efficacious alternative with superior cosmetic outcomes, postoperative recovery compared with an OA or umbilicoplasty.
Topics: Adolescent; Adult; Aftercare; Allantois; Blood Loss, Surgical; Cystoscopy; Female; Humans; Laparoscopy; Length of Stay; Male; Minimally Invasive Surgical Procedures; Operative Time; Retrospective Studies; Tomography, X-Ray Computed; Treatment Outcome; Umbilicus; Urachal Cyst; Urachus; Young Adult
PubMed: 29952943
DOI: 10.1097/MD.0000000000011043 -
Canadian Journal of Surgery. Journal... Apr 2001
Topics: Abdominal Pain; Diagnosis, Differential; Drainage; Female; Humans; Infant; Infections; Leukocyte Count; Leukocytosis; Tomography, X-Ray Computed; Ultrasonography; Urachal Cyst
PubMed: 11308234
DOI: No ID Found -
Ultrasound in Obstetrics & Gynecology :... Jan 1992The umbilical cord has been inadequately studied by ultrasound. Umbilical cord masses are rare and often misdiagnosed.A case of a 4.3 x 3.2 cm anechoic floating cystic...
The umbilical cord has been inadequately studied by ultrasound. Umbilical cord masses are rare and often misdiagnosed.A case of a 4.3 x 3.2 cm anechoic floating cystic umbilical mass is reported. Doppler examination of the cord proximal to the cyst revealed a high resistance index of 0.84. Twelve hours later the cyst was larger (5.0 x 4.5 cm) and appeared tense; Doppler velocimetry worsened and absence of end-diastolic flow in the umbilical artery was found. Cardiotocography a few hours later showed a bradycardiac non-reactive trace with late decelerations. A live male weighing 1980 g was delivered by Cesarean section. At birth the cord position was normal. Pathological examination showed the lesion to be consistent with an allantoic cyst. This is the first case in which antenatal evidence of cord compression by an expanding allantoic cyst has been demonstrated.
PubMed: 12797010
DOI: 10.1046/j.1469-0705.1992.02010058.x