Hospital of The Forces and The Security of Interior La Marsa Tunis, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia.
J Med Case Rep. 2023 May 24;17(1):214. doi: 10.1186/s13256-023-03944-8.
Abnormalities of the urachus include the patent urachus, cysts, sinus, and fistula. Each of these entities represents a failure of complete obliteration of the urachus. Contrary to other urachus anomalies, urachal cysts are usually small and silent unless they are infected. The diagnosis is often made during childhood. A benign noninfected urachal cyst discovered in adulthood is a rare condition.
Herein we report two cases of benign noninfected urachal cysts in adults. The first case is a 26-year-old Tunisian white man who presented with complaints of clear fluid draining from the base of the umbilicus evolving for a week, with no other associated symptoms. The other case was 27-year-old Tunisian white woman who was referred to the surgery department with a history of intermittent draining of clear fluid from the umbilicus. The two cases had laparoscopic resection of urachus cysts.
Laparoscopy represents a good alternative for the management of persistent or infected urachus, especially when this is suspected, despite a lack of radiological evidence. Laparoscopy in the management of urachal cysts is safe, effective, and offers good cosmesis, with all the advantages of a minimally invasive approach.
Managing persistent and symptomatic urachal anomalies requires a wide surgical excision. Such intervention is recommended to prevent symptom recurrence and complications, most notably malignant degeneration. A laparoscopic approach offers excellent outcomes, and is recommended to treat these abnormalities.
脐尿管异常包括脐尿管未闭、囊肿、窦道和瘘管。这些异常都是由于脐尿管未能完全闭合导致的。与其他脐尿管异常不同，脐尿管囊肿通常较小且无症状，除非感染。诊断通常在儿童期进行。成人中发现的良性非感染性脐尿管囊肿是一种罕见的情况。
本文报告了两例成人良性非感染性脐尿管囊肿。第一例是一位 26 岁的突尼斯白人男性，他因脐部底部有清亮液体流出，持续了一周，无其他相关症状就诊。另一个病例是一位 27 岁的突尼斯白人女性，因间歇性脐部有清亮液体流出而被转至外科。这两例患者均接受了腹腔镜下脐尿管囊肿切除术。
腹腔镜检查是治疗持续性或感染性脐尿管的一种较好的替代方法，尤其是在怀疑存在这种情况时，尽管缺乏放射学证据。腹腔镜检查在处理脐尿管囊肿方面是安全、有效的，并且具有良好的美容效果，同时具有微创方法的所有优势。
对于持续性和有症状的脐尿管异常，需要广泛的手术切除。这种干预措施可预防症状复发和并发症，尤其是恶性转化。腹腔镜方法可提供良好的治疗效果，是治疗这些异常的推荐方法。
