國軍台中總醫院 外科部1 泌尿科；國防醫學院 醫學系2
Urachal remnants abscess presenting with acute abdomen in young female: A case report and literature review
Bo-Ren, Wang1,2, Chin-Cheng, Yi1,2, Jane-Dar, Lee1,2
Divisions of Urology, Department of Surgery, Taichung Armed Forces General Hospital, Taichung, Taiwan1; National Defense Medical Center, Taipei, Taiwan2
A 21-year-old female complained of low abdominal pain for 5 days. Initially, she didn’t pay much attention to it, however, the symptoms got worse and she turned to emergent department for further exam. Physical exam revealed severe local tenderness over infraumbilical region, with extended to the pubic symphysis region. Urine test results were negative. CT of abdomen was checked which revealed a urachal remnant arising from the anterior/superior margin of the bladder and extending to the umbilical region. Besides, an abscess formation of the urachal remnants near umbilical region was identified. There was no discharge of the umbilicus identified, only mild erythematous of the umbilical region was noted. The patient received empiric antibiotics for infection control and general recovered well.
The urachus, a vestigial structure connecting the bladder dome to umbilicus, occludes and normally becomes a fibrous cord after birth. If occlusion is insufficient, a urachal remnant forms and may eventually become infected. Urachal remnant abnormalities are uncommon in adults and are twice as likely in men than in women. After resolution of the infection, there are recommendations that the urachal remnant should be excised to prevent recurrent infection and avoid the risk of neoplastic transformation