Akademik Veri Yönetim Sistemi
7th İnternatıonal Zeugma Conference on Scıentıfıc Researches, Gaziantep, Türkiye, 21 Ocak 2022, ss.23-24
INFECTED
URACHAL CYST DIAGNOSED AT ADULT AGE: PRESENTATION OF OUR SURGICAL APPROACH
ACROSS OUR CASES
ABSTRACT
At the beginning of
intrauterine life, there is a urachus connection between the allontois sac and
the bladder. During late fetal development or early infancy (<6 months), the
urachus obliterates into a fibrous band called the median umbilical ligament.
If urachal obliteration does not occur, four different embryological
malformations known as urachal fistula, urachal cyst, urachal sinus, and
urachal diverticulum may occur. Rarely, urachal remnants may not be recognized
until adulthood. Urachal cyst can mimic acute appendicitis, Meckel's
diverticulum or incarcerated hernia and can be confused with acute abdomen.
Diagnosis can be made with imaging methods and it can be diagnosed and treated
without creating findings such as abscess, sepsis or fistula.
Our cases were two female
patients aged 20 and 28 years. Our first patient, a 28-year-old female patient,
presented with an abscess formation of approximately 5-6 cm in the inferior of
the umbilicus. The other patient has a history of appendectomy operation 7
years ago. She admitted to hospital with the complaint of intermittent fluid
discharge from skin below the umbilicus. In the abdominal computed tomography
of both patients, an infected urachus cyst was detected in the inferior of the
umbilicus, behind the rectus muscles. Antibiotherapy was started in both
patients. The patients had leukocytosis. An abscess drainage catheter was
inserted in one patient. However, the clinical picture did not regress. In the
other patient, there was no abscess that could drain after antibiotic
treatment. The patients were operated. In both patients, the urachal cyst was
completely excised. Perop bladder injury developed in one patient and primary
repair was performed. No malignancy was observed in pathological examinations,
and when evaluated together with the clinic, it was reported as an infected
urachal cyst. The patients were discharged with good recovery after
postoperative follow-up.
In conclusion,
infection due to urachal cyst is a rare condition in adults. Umbilical
discharge should be considered in the presence of a mass or abscess formation
that may occur under the umbilicus and in the midline. Although abscess
drainage and antibiotic therapy can be used in its treatment, total excision
should be performed due to the risk of malignancy.
Key
words: infected urachal cyst, surgical approach, adult urachal cyst