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

Aleix Soler-Garcia, Sonia Pérez Bartólez, Vanessa Arias Constantí, Núria Elvira Sanz Marcos

Abstract


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.



Keywords


Urachal cyst, urachal remnant, children, non-operative management

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References


Chiarenza SF, Bleve C. Laparoscopic management of urachal cysts. Transl Pediatr. 2017;5(4):275-81.

Gimeno Argente V, Domínguez Hinarejos C, Serrano Durbá A, et al. Infected urachal cyst during childhood. Actas Urol Esp. 30(10):1034-37.

El Ammari JE, Ahallal Y, El Yazami Adli O, et al. Urachal Sinus Presenting with Abscess Formation. ISRN Urol. 2011;2011:1-3.

Lipskar AM, Glick RD, Rosen NG, et al. Nonoperative management of symptomatic urachal anomalies. J Pediatr Surg. 2010;45(5):1016-19.

Azurmendi Sastre V, Llarena Ibarguren R, Lozano Ortega JL, et al. Urachal cyst. Current status. Arch Esp Urol. 2003;56(9):999-1004.

Tazi F, Ahsaini M, Khalouk A, et al. Abscess of urachal remnants presenting with acute abdomen: a case series. J Med Case Rep. 2012;6(1):226.

Ashley RA, Inman BA, Routh JC, et al. Urachal anomalies: a longitudinal study of urachal remnants in children and adults. J Urol. 2007;178(4 Pt 2):1615-18.

Naiditch JA, Radhakrishnan J, Chin AC. Current diagnosis and management of urachal remnants. J Pediatr Surg. 2013;48(10):2148-52.

Heuga B, Mouttalib S, Bouali O, et al. Prise en charge des résidus de l’ouraque au cours de l’enfance : l’exérèse chirurgicale est-elle obligatoire ? Progrès en Urol. 2015;25(10):603-606.

Dethlefs CR, Abdessalam SF, Raynor SC, et al. Conservative management of urachal anomalies. J Pediatr Surg. February 2019. doi:10.1016/j.jpedsurg.2019.01.039

Ekwueme KC, Parr NJ. Infected urachal cyst in an adult: a case report and review of the literature. Cases J. 2009;2(1):6422.

Nogueras-Ocaña M, Rodríguez-Belmonte R, Uberos-Fernández J, et al. Urachal anomalies in children: Surgical or conservative treatment? J Pediatr Urol. 2014;10(3):522-26.

Galati V, Donovan B, Ramji F, et al. Management of urachal remnants in early childhood. J Urol. 2008;180(4 Suppl):1824-1826; discussion 1827.

Yoo KH, Lee S-J, Chang S-G. Treatment of infected urachal cysts. Yonsei Med J. 2006;47(3):423-27.

Upadhyay V, Kukkady A. Urachal remnants: an enigma. Eur J Pediatr Surg. 2003;13(6):372-76.

Muśko N, Dobruch J, Piotrowicz S, et al. Infected urachal cyst in a young adult. Cent Eur J Urol. 2014;67(2):199-201.

Ueno T, Hashimoto H, Yokoyama H, et al. Urachal anomalies: ultrasonography and management. J Pediatr Surg. 2003;38(8):1203-1207.

Gleason JM, Bowlin PR, Bagli DJ, et al. A comprehensive review of pediatric urachal anomalies and predictive analysis for adult urachal adenocarcinoma. J Urol. 2015;193(2):632-36.

Sato H, Furuta S, Tsuji S, Kawase H, Kitagawa H. The current strategy for urachal remnants. Pediatr Surg Int. 2015;31(6):581-87.

Gami BL, Biswas S. An infected urachal cyst. BMJ Case Rep. 2013;2013 (feb21 1):bcr2012007105-bcr2012007105.




DOI: http://dx.doi.org/10.14534/j-pucr.2020359807

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