Faye P M, Gueye M L, Thiam O, Niasse A, Ndong A, Ndiaye M, Seye Y, Sarr I S S, Seck M, Toure A O, Cisse M
General Surgery department of Dalal Jamm Hospital, Dakar, Senegal.
General Surgery department of Aristide Le Dantec Hospital, Dakar, Senegal.
Int J Surg Case Rep. 2022 Aug;97:107394. doi: 10.1016/j.ijscr.2022.107394. Epub 2022 Jul 8.
Urachus is an embryonic remnant that usually involutes before birth. Abnormal persistence of this structure gives embryologic malformation like an urachal cyst. Infection or malignancy degeneration can complicated it.
Case 1: We report 20 years old female patient consulted with acute abdominal pain. Clinical examination showed fever and infra-umbilical tender mass. The abdominal Computerized Tomography showed pelvic mass between umbilicus and bladder. The open laparotomy found infra-abdominal semi-solid mass. A complete resection was done and histological exam confirmed infected urachal cyst. Case 2: A 19 years old male patient presented with abdominal pain and fever. Physical examination found tenderness in lower abdomen. Biology revealed leukocytosis, and Ultrasonography found a heterogeneous infra-umbilical mass. Surgical exploration by mini-laparotomy found an abscess urachal cyst that is confirm by histological exam after complete resection.
Urachal cyst in adult patient is rare. Clinical symptoms without complications are insignificant. Because of malignancy risk, adult urachal cyst are managed by surgery.
Infection cyst is the most common complication of urachal cyst. Complete resection is recommended because of malignancy degeneration risk.
脐尿管是一种胚胎残余物,通常在出生前退化。该结构异常持续存在会导致诸如脐尿管囊肿等胚胎畸形。感染或恶性变会使其复杂化。
病例1:我们报告一名20岁女性患者,因急性腹痛前来就诊。临床检查显示发热及脐下压痛性肿块。腹部计算机断层扫描显示脐部与膀胱之间有盆腔肿块。开腹手术发现腹下有半固体肿块。进行了完整切除,组织学检查证实为感染性脐尿管囊肿。病例2:一名19岁男性患者出现腹痛和发热。体格检查发现下腹部压痛。生物学检查显示白细胞增多,超声检查发现脐下有一不均匀肿块。经小切口剖腹手术探查发现一个脐尿管囊肿脓肿,完整切除后经组织学检查得以证实。
成年患者的脐尿管囊肿罕见。无并发症的临床症状不明显。由于存在恶性风险,成年脐尿管囊肿需通过手术治疗。
感染性囊肿是脐尿管囊肿最常见的并发症。由于存在恶性变风险,建议进行完整切除。