medigraphic.com

2013, Number 4

<< Back Next >>

Cir Cir 2013; 81 (4)

Giant abscessed urachal cyst in adult. Case report

Ponce-Pérez LV, Cárdenas-Lailson LE, Domínguez-Muñoz G, López-Díaz YA, Vera-Rodríguez F

Language: Spanish
References: 22
Page: 348-352
PDF size: 385.20 Kb.


ABSTRACT

Background: during gestation, the urachus represents the connection between the dome of the bladder and the allantoic duct. This infection occurs preferentially in young adults, advocating the haematogenous or lymphatic pathway as possible routes of transmission, while a cord or bladder origin may also occur. Is uncomund in adult life, and is only the 2%.
Clinic case: thirty years male patient with a history of alcoholic hepatitis, diabetes mellitus type 2, chronic malnutrition, increased volume beginning with generalized abdominal pain, abdominal tumor of 20 for 15 cm, mobile, solid, without signs of peritoneal irritation. TC with presence of tumor probably dependent of bladder, apparently cystic. Exploratory laparotomy was found infected urachal cyst, draining purulent material 3,000 cc, partial resection of the anterior face, keeping the back by firm adherence to bowel loops. Evolving satisfactorily.
Discussion: urachal abnormalities are rare, with male / female ratio of 2 / 1. Although urachal abscess is an infection confined to an enclosed space, definitive treatment should not be the simple incision and drainage, because the possibility of malignant transformation of urachal remnants. The definitive treatment should be considered complete excision of urachal cyst and when the infection is limited.
Conclusion: the urachus cyst is a rare pathology and is a diferencial diagnosis for acute appendicitis and need to know this treatment.


REFERENCES

  1. Moore K, Persaud T, Shiota K, Sulik K, Landcaster P, Kirby M, et al. Before We Werw Born: Essentials of Embryology and Birth Defects. Philadelphia: WB Saunders, 1998;300-320.

  2. MacNeily AE, Koleilata N, Kiruluta HG, Homsy YL. Urachal abscesses: Protean manifestations, their recognition, and management. Urology 1992;40:530-535.

  3. Goldman IL, Caldamone AA, Gauderer M, Hampel N, Wesselhoeft CW, Elder JS. Infected urachal cysts: A review of 10 cases. J Urol 1988;140:375-378.

  4. Mesrobian HGO, Zacharias A, Balcom AH, Cohen RD. Ten Years of Experience With Isolated Urachal Anomalies in Children. J Urol 1997;158:1316-1318.

  5. Cilento BG, Bauer SB, Retik AB, Peters CA, Atala A. Urachal anomalies: defining the best diagnostic modality. Urology 1998;52:120-122.

  6. Yiee JH, Garcia N, Baker LA, Barber R, Snodgrass WT, Wilcox DT. A diagnostic Algorithm for urachal anomalies. J Pediat Urology 2007;3:500-504.

  7. Upadhyay VV, Kukkady AA. Urachal Remnants: An Enigma. Eur J Pediatr Surg 2003;13:372-376.

  8. Ward TT, Saltzman E, Chiang S. Infected Urachal Remnants in the Adult: Case Report and Review. Clin Infect Dis 1993;16:26-29.

  9. Bourne CW, May JE. Urachal remnants: benign or malignant? J Urol 1977;118:743-747.

  10. Ohman U, Garrelts BV, Moberg A. Carcinoma Of The Urachus. Scand J Urol Nephrol 1971;5:91-95.

  11. Ueno T, Hashimoto H, Yokoyama H, Ito M, Kouda K, Kanamaru H. Urachal anomalies: ultrasonagraphy and management. J Pediatr Surg 2003;38:1203-1207.

  12. Blichert-Toft M, Koch F, Nilsen OV. Anatomic variants of the urachus related to clinical appearance and surgical treatment of urachal lesions. Obstetrics 1973;137:51-54.

  13. Blichert-Toft M, Nielsen OV. Diseases of the urachus simulating intra-abdominal disorders. Am J Surg 1971;122:123-128.

  14. Ekwueme KC, Parr N. Infected urachal cyst in an adult: a case report and review of the literature. Cases J 2009;2:6422-6425.

  15. Yoo KH, Lee SJ, Chang SG. Treatment of Infected Urachal Cysts. Yonsei Med J 2006;47:423-427.

  16. Chiarenza S, Grazia M, D’Agostino S, Fabbro M, Novek S, Musi L. Laparoscopic Excision of Urachal Cyst in Pediatric Age: Report of Three Cases and Review of the Literature. J Laparoendoscopic Advanced Surgical Techniques 2009;19(s1):s183-s186.

  17. Khurana S, Borzi PA. Laparoscopic Management of Complicated Urachal Disease in Children. J Urol 2002;168:1526-1528.

  18. Le Picard P, Carion G. Traitment laparoscopique extrapéritonéal du kyste du canal de l’auraque. J Chir 2003;140:66.

  19. Lipskar AM, Glick RD, Rosen NG, Layliev J, Hong AR, Dolgin SE. Nonoperative Management of symptomatic urachal anomalies. J Pediat Surgery 2010;45:1016-1019.

  20. Peters CA. Laparoscopic and robotic approach to genitourinary anomalies in children. Urol Clin North Am 2004;31:595-605.

  21. Yamzon J, Kokorowski P, De Filippo RE, Chang AY, Hardy BE, Koh CJ. Pediatric Robot-Assisted Laparoscopic Excision of Urachal Cyst and Bladder Cuff. J Endourology 2008;22:2385-2388.

  22. Quicios-Dorado C, Fernández-Fernández E, Gómez-García I, García- Flórez D, De Castro-Guerin C, Escudero-Barrilero A. Retención aguda de orina, RAO, como presentación de quiste de uraco. Actas Urol Esp 2005;29:909-912.




2020     |     www.medigraphic.com