Urachal Sinus Presenting with Abscess Formation

Ammari, Jalal Eddine El; Ahallal, Y.; Adli, Oussama El Yazami; Fassi, Mohammed Jamal El; Farih, Moulay Hassan

doi:10.5402/2011/820924

Cited by 12 publications

(19 citation statements)

References 8 publications

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“…One possible explanation could be that the urachal sinus is often associated with non-specific symptoms and is largely asymptomatic unless it develops a complication (most commonly infection). [ 4 , 25 , 26 ] Another possible explanation could be its anatomical location; indeed, it is not located near the urinary bladder and if asymptomatic it may not be observed during an abdominal ultrasound examination.…”

Section: Discussionmentioning

confidence: 99%

Ultrasonographic Diagnosis of Urachal Anomalies in Cats and Dogs: Retrospective Study of 98 Cases (2009–2019)

Perondi

Puccinelli

Lippi

et al. 2020

Veterinary Sciences

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This retrospective study investigated the prevalence of different urachal anomalies (UA) in cats (n = 60) and dogs (n = 38) and their association with clinical symptoms and urinalysis alterations. Among UA, the vesicourachal diverticulum was the most prevalent UA diagnosed in both cats (96.7%) and dogs (89.5%): the intramural vesicourachal diverticulum was diagnosed in 76.7% of cats and 71.1% of dogs, followed by extramural vesicourachal diverticulum (20.0% and 18.4% respectively). In both cats and dogs, bladder wall diffuse or regional thickening was the most prevalent alteration. The most common alterations of the urinary bladder content were urolithiasis sediment in cats (33.3%) and in dogs (31.6%). Dogs with UA were more often asymptomatic (p = 0.01). No difference was found in cats. Stranguria, hematuria, and urethral obstruction were the most frequently reported clinical signs, while hematuria and leukocyturia were the most prevalent abnormalities at urinalysis. In conclusion, our study confirmed UA as uncommon, and often incidental findings, with a high prevalence of animals without clinical signs.

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Section: Discussionmentioning

confidence: 99%

Ultrasonographic Diagnosis of Urachal Anomalies in Cats and Dogs: Retrospective Study of 98 Cases (2009–2019)

Perondi

Puccinelli

Lippi

et al. 2020

Veterinary Sciences

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“…Persistence of a urachal sinus is a rare clinicopathological entity that boasts a meagre prevalence of one in 5,000 live births and usually presents in male children [5]. Its occurrence in adults is even rarer, with a prevalence rate hovering around 2% of the total reported cases [6]. Since urachal sinuses are predominantly encountered in the pediatric population, they often do not merit a place in the list of differential diagnosis surrounding umbilical discharge or lower abdominal pain in an adult male.…”

Section: Discussionmentioning

confidence: 99%

“…A perusal and evaluation of the published medical literature reveals that cases of infected urachal sinuses can manifest with a vague constellation of clinical symptoms, including umbilical discharge, erythema, lower abdominal pain, fever, and burning micturition [6,7]. In a multitude of instances, a urachal sinus can be secondarily infected, usually with Escherichia coli, and form an abscess, thereby leading to abdominal pain and a purulent umbilical discharge [8].…”

Section: Discussionmentioning

confidence: 99%

Urachal Sinus Complicated by an Umbilical Abscess

Almas¹,

Khan²,

Fatima³

et al. 2020

Cureus

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The urachal sinus is a vestigial remnant that ensues in the aftermath of incomplete obliteration of the embryonic urachus. Urachal sinuses often remain asymptomatic, being discovered incidentally in instances where they are complicated with a superimposed infection or abscess. Due to their rare occurrence in adults, urachal sinuses are rarely included in the list of differential diagnosis surrounding umbilical pain in adult patients. We hereby delineate a unique case of a urachal sinus in a 26-year-old male patient. Due to the presence of an abscess in a hirsute male, a presumptive diagnosis of an umbilical pilonidal sinus was suspected. However, further diagnostic workup divulged an unequivocal diagnosis of a urachal sinus complicated by an abscess formation.

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“…Infected cysts can present with a tender midline mass below the umbilicus. Many types can present with umbilical discharge [ 5 ]. Hirose et al described a case of a middle-aged man who presented with umbilical discharge where an abscess had formed at the urachal remnant, requiring drainage and intravenous antibiotics [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

“…The innermost lining of a urachal remnant is comprised of transitional epithelium. Chronic inflammation can lead to metaplasia, principally adenocarcinoma [ 5 , 7 ].…”

Section: Discussionmentioning

confidence: 99%

An Adult with a Remnant Urachus Anomaly Diagnosed in the Emergency Department

Lucerna

Lee

Espinosa

et al. 2018

Case Reports in Emergency Medicine

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The urachus is a midline tubular structure that stretches from the apex of the bladder and connects to the umbilicus. Urachal remnants result from incomplete regression of the fetal urachus in infancy. We report the case of a 21-year-old male who presented to the emergency department with purulent drainage from his umbilicus in association with a chronic intermittent “pulling sensation” in the umbilicus and suprapubic areas. An infected urachal remnant was diagnosed and was treated with an oral antibiotic and ultimately with outpatient excision of the remnant. Such cases are rare but have the potential to progress to sepsis. In addition, chronic inflammation can lead to neoplastic transformation (adenocarcinoma). Urachal remnant infections can be considered in adults with umbilical purulent drainage. We propose that the “pulling sensation” described may be a clue to the diagnosis in some patients in which the urachal remnant is attached to the bladder and that the sensation was due to the mechanical connection between the bladder and the umbilicus. The sensation resolved postremoval status of the remnant. This does not appear to have been previously proposed in the literature.

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Urachal Sinus Presenting with Abscess Formation

Cited by 12 publications

References 8 publications

Ultrasonographic Diagnosis of Urachal Anomalies in Cats and Dogs: Retrospective Study of 98 Cases (2009–2019)

Ultrasonographic Diagnosis of Urachal Anomalies in Cats and Dogs: Retrospective Study of 98 Cases (2009–2019)

Urachal Sinus Complicated by an Umbilical Abscess

An Adult with a Remnant Urachus Anomaly Diagnosed in the Emergency Department

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