Laparoscopic treatment of an infected urachalcyst and diverticulum in a young adult: Presentation of a case and review of the literature

Passoni, Stefano; Guerra, Adriano; Marengo, Michele

doi:10.1016/j.ijscr.2018.06.018

Cited by 9 publications

(16 citation statements)

References 12 publications

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“…Urachal anomalies are observed in the general population at a rate of 1:5,000. 6 They are often detected incidentally and remain asymptomatic. Sometimes they are confused with other abdominal and pelvic diseases in emergency departments.…”

Section: Discussionmentioning

confidence: 99%

Evaluation and management of urachal remnants in children

Orbatu

Alaygut

2020

Pediatrics International

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Background: This study aimed to evaluate the diagnosis and treatment of pediatric patients with urachal remnants. Methods: Medical records of patients diagnosed with urachal remnants between 2015-2019 were evaluated retrospectively. Age, gender, admission complaints, diagnosis, size of cysts, the complications that developed, and treatment modalities were recorded. Results: The study population consisted of 15 cases including seven girls. Most of the cases were asymptomatic. The urachal remnants were detected by ultrasonography. The most common symptom in symptomatic patients was abdominal pain and umbilical discharge. Three patients required surgery and most of them were conservatively followed up. Complication, infection, and bladder rupture were observed in one case. Conclusions: Follow-up of patients with urachal remnants can be performed conservatively. The type of complaint and the presence of clinical and radiological regression (if any) are important for deciding the treatment during the follow-up. However, conservative follow-up is more prominent today, as shown in this study.

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Section: Discussionmentioning

confidence: 99%

Evaluation and management of urachal remnants in children

Orbatu

Alaygut

2020

Pediatrics International

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“…Total surgical excision should be performed after the infection has cleared [ 1 ]. This two-stage approach is considered by most as the treatment of choice [ 2 , 5 ]. It emphasizes infection resolution before surgical intervention as superior, for reducing the risk of postoperative complications, like wound infection or urine leak, as well as reducing hospital stay [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

“…Urachal remnant anomalies are rare in adulthood, with a reported incidence of 1 : 5000 in adults, and a higher prevalence in men than women with a ratio 2 : 1 [ 1 , 2 ]. The urachus is an embryologic remnant of the cloaca and the allantois [ 1 ], and incomplete obliteration of its lumen results in four different types of urachal anomalies [ 1 , 2 ]. Vesicourachal diverticulum, where there is a persistence of the vesical portion of the urachus, is the most uncommon, accounting for approximately 3% to 5% of congenital urachal anomalies [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Management of an Infected Vesicourachal Diverticulum in a 42-Year-Old Woman

Erodotou

Isaia

Fragkiadakis

et al. 2020

Case Reports in Urology

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Urachal remnant anomalies are uncommon in adults and can be confused with a variety of clinical conditions when symptomatic or infected. Vesicourachal diverticulum is the rarest type, accounting for approximately 3% to 5% of congenital urachal anomalies. We report the case of a 42-year-old female patient, who presented to the emergency department with lower abdominal pain and a palpable abdominal mass. An infected vesicourachal diverticulum was diagnosed after imaging studies and was initially treated with intravenous antibiotic therapy and drainage of the urachal diverticulum to the urinary bladder through a JJ stent. Finally, the patient underwent open surgical excision of the urachal remnant. The postoperative course was uneventful, and the histopathological examination confirmed the diagnosis of vesicourachal diverticulum. We recommend drainage of an infected vesicourachal diverticulum through the bladder by JJ stent placement inside its lumen during cystoscopy, as an alternative to percutaneous drainage reported in the literature.

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“…The incidence of urachal anomalies is about 1:5000 in general population [1]. Based on the location of abnormal residual patency along the urachal tract, four types of congenital urachal anomalies are present, including patent urachus, urachal sinus, urachal cyst and vesicourachal diverticulum (Table II) [3].…”

Section: Discussionmentioning

confidence: 99%

“…The urachus originates from the allantois and cloaca and extends between the bladder dome and the umbilicus. With normal embryonic development, the urachus involutes and its lumen is obliterated, becoming the median umbilical ligament [1]. Due to an incomplete obliteration of the urachus, urachal anomalies may present along the urachal tract and give rise to various clinical pathological situations such as inflammation, infection, umbilical discharge, lower abdominal pain and potential malignancy [2].…”

Section: Introductionmentioning

confidence: 99%

Ultrasound findings of urachal anomalies. A series of interesting cases

Luo

Lin

et al. 2019

Med Ultrason

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Aims: This study’s aim is to present the specific ultrasonography (US) findings of a series of urachus anomalies. Material and methods: Seven patients with suspected urachal anomalies underwent US scanning initially prior to the surgery and the features of images were reviewed respectively. The clinical data and pathologic results were collected also. Results: US successfully diagnosed urachal anomalies in 5 patients (5/7, 71.4%) and failed to diagnose in 2 patients (2/7, 28.6%). Patent urachus showed a tubule between the umbilicus and bladder; urachal sinus was a blind focal dilatation at the umbilical end, while vesicourachal diverticulum was an outpouching at the vesical end and urachal cyst was identified as an anechoic structure along the urachus. Non-enhancement in the base and centre was the distinct features of urachus carcinoma by contrastenhanced ultrasonography (CEUS). Using a high frequency probe and CEUS the diagnostic ability of US may be improved. Conclusion: US showed good diagnostic ability in urachal anomalies and combined with CEUS could improve the differential diagnosis.

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Laparoscopic treatment of an infected urachalcyst and diverticulum in a young adult: Presentation of a case and review of the literature

Abstract: HighlightsUrachal remnant anomalies are uncommon in adulthood.Surgical removal of urachal remnants is indicated to prevent recurrent infection.Urachal carcinoma is a rare but aggressive cancer.Laparoscopic approach represents the safest approach to remove urachal remnant.

Cited by 9 publications

References 12 publications

Evaluation and management of urachal remnants in children

Evaluation and management of urachal remnants in children

Management of an Infected Vesicourachal Diverticulum in a 42-Year-Old Woman

Ultrasound findings of urachal anomalies. A series of interesting cases

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