切除臍尿管囊腫膿瘍後施行肚臍成形術: 病例報告及文獻回顧

何宣瑩、劉建良、沈坤宏

奇美醫學中心 外科部 泌尿外科

Neoumbilicoplasty after excision of urachal cyst with abscess: a case report and review of literature

Hsuan-Ying Ho, Chien-Liang Liu

Division of Urology, Department of Surgery, Chi Mei Medical Center, Taiwan

Purpose: Urachal abnormalities result from incomplete regression of the fetal urachus. In adults, urachal cyst (UC) is the commonest variety, with infection being the usual mode of presentation. Surgical intervention is the treatment of choice, and complete excision is important because malignant degeneration is possible. We present a case of an infected urachal cyst with purulent umbilical discharge, and the patient receives wide excision and neoumbilicoplasty by using a local flap. In the article, we will also review the literature on infected urachal cyst and the management.

Case report: A 35-year-old man, who has no history of systemic diseases, complains of umbilical pain for 2 weeks. There are also purulent umbilical discharge, local redness, and tenderness. Similar episode was mentioned three months ago. At that time, he was treated with antibiotics in local clinic, and Staphylococcus infection was told. There is no fever, chills, diffuse abdominal pain, nor other discomfort. Abdominal CT revealed umbilical fistula. Antibiotics are given for infection control. Considering the urachal abnormality, surgical excision is suggested. After wide excision of the urachal cyst, plastic surgeon is consulted for reconstruction. Bilateral trapezoid advancement flaps are used to reconstruct the umbilicus. The surgery and recovery are uneventful and the patient receives follow-up at our outpatient department.