Qureshi Khalid, Maskell David, McMillan Colin, Wijewardena Chandana
Department of Surgery, Queen Elizabeth Hospital, Kings Lynn, United Kingdom.
Int J Surg Case Rep. 2013;4(7):633-5. doi: 10.1016/j.ijscr.2013.02.026. Epub 2013 Apr 19.
An infected urachal cyst is one of a spectrum of presentations of urachal pathology, all of which are rare in adulthood.
We report the case of a 45-year-old obese Russian lady who presented with a 2-week history of suprapubic pain radiating to the right iliac fossa. Although previously fit and well, she had a history of 17 miscarriages. Both USS and CT suggested a complicated inflammatory mass in the lower abdomen. Ultimately the diagnosis was made by laparotomy, which revealed an abscess of an urachal cyst. The infected cyst and bladder dome were excised. The patient made a good recovery with an uneventful follow up.
Urachal cysts are the commonest type of urachal anomaly. Infection is the usual mode of presentation amongst adult cases otherwise the condition usually remains asymptomatic. An infected urachal cyst is an important diagnosis to make as complications include sepsis, fistula formation, and rupture leading to peritonitis. Treatment is by complete excision, however, techniques have been debated.
This is a rare but important diagnosis however we recommend that in patients with atypical histories, it should be included in the differential diagnosis.
感染性脐尿管囊肿是脐尿管病变的一系列表现之一，所有这些在成年期都很罕见。
我们报告一例45岁肥胖的俄罗斯女性病例，患者有2周的耻骨上疼痛病史，疼痛放射至右髂窝。尽管她之前身体健康，但有17次流产史。超声检查和计算机断层扫描均提示下腹部有一个复杂的炎性肿块。最终通过剖腹手术确诊，发现为脐尿管囊肿脓肿。切除了感染的囊肿和膀胱顶部。患者恢复良好，随访过程顺利。
脐尿管囊肿是最常见的脐尿管异常类型。感染是成人病例中常见的表现方式，否则该疾病通常无症状。感染性脐尿管囊肿是一个重要的诊断，因为并发症包括败血症、瘘管形成和破裂导致腹膜炎。治疗方法是完全切除，然而，技术一直存在争议。
这是一个罕见但重要的诊断，然而我们建议，对于有非典型病史的患者，应将其纳入鉴别诊断。
