Ekwueme Kingsley C, Parr Nigel J
Department of Urology, Wirral University Teaching Hospital Wirral, Merseyside UK.
Cases J. 2009 Jun 25;2:6422. doi: 10.4076/1757-1626-2-6422.
Urachal cyst is one of a spectrum of urachal abnormalities most commonly found in children. They are very rarely seen in adults because the urachus is normally obliterated in early infancy.
We describe a case of a 32 year old male Caucasian who presented with a tender, midline, infraumbilical mass and purulent umbilical discharge. Diagnosis of an infected urachal cyst was confirmed on magnetic resonance scan. He was treated initially with broad spectrum antibiotics in order to allow sepsis to resolve prior to surgical excision of the cyst and fibrous tract. Cystoscopy was performed intraoperatively to exclude sinus communication with the bladder. Histology of the excised specimen showed chronic inflammation with no evidence of malignancy. Postoperative recovery was uneventful.
Urachal abnormalities are rare in adults. Clinical presentation is non-specific; therefore, a high index of suspicion is required in order to make the diagnosis. When diagnosed, surgical excision is advised because of the risk of malignant transformation.
脐尿管囊肿是一系列脐尿管异常疾病之一，最常见于儿童。在成人中很少见，因为脐尿管通常在婴儿早期就已闭锁。
我们描述了一例32岁的白种男性病例，患者表现为脐下中线处有压痛性肿块及脓性脐部渗液。磁共振扫描确诊为感染性脐尿管囊肿。最初给予广谱抗生素治疗，以便在手术切除囊肿及纤维条索之前控制败血症。术中进行膀胱镜检查以排除与膀胱的窦道相通。切除标本的组织学检查显示为慢性炎症，无恶性证据。术后恢复顺利。
脐尿管异常在成人中罕见。临床表现无特异性；因此，为了做出诊断需要高度怀疑。一旦确诊，由于存在恶变风险，建议手术切除。
