Infected Urachal Remnants with Symtoms of the Acute Abdomen: The Differential Diagnosis & Proper Management.
- Author:
Jan Dy LEE
1
;
Chee Young LIM
;
Hyoung Il KIM
;
Chul Woon CHUNG
;
Jong Woo KIM
;
Dae Ho AHN
;
Seung Ki KIM
;
Suk Woo SOHN
;
Kyung Po LEE
;
Kyung Sik LEE
Author Information
1. Department of Surgery, College of Medicine, Pochon CHA University, Seongnam, Korea. wehrwolf@hamail.net
- Publication Type:Original Article
- Keywords:
Urachal anomalies;
Urachal remnants;
Urachal cyst;
Acute abdomen
- MeSH:
Abdomen, Acute*;
Abdominal Pain;
Diagnosis;
Diagnosis, Differential*;
Female;
Hospitalization;
Humans;
Male;
Referral and Consultation;
Rupture;
Sepsis;
Ultrasonography;
Urachal Cyst
- From:Journal of the Korean Surgical Society
2004;67(4):320-324
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Urachal anomalies are rare, but often give rise to a number of problems, such as infection, rupture, sepsis and malignant change. The abdominal manifestation of urachal remnants often prompts referral to general or urologic surgeons. Herein, our clinical experiences were analyzed and guide lines for the preoperative diagnosis and proper management of complicated urachal anomalies suggested. METHODS: Twelve cases of urachal cyst, who visited the surgery department of Pochon CHA university hospital between April 1, 1995 and December 10, 2002, were studied. Clinical data, including clinical manifestations, diagnostic modalities and treatment methods were reviewed. RESULTS: Of the twelve cases reviewed, nine were males and three were females with a mean age of 33.6 years. The most common clinical manifestation was abdominal pain (58%), followed by a palpable mass (25%). The accuracies of the diagnostic modalities were 60 and 37% for abdominopelvic computed tomography and abdominal ultrasonography, respectively. The preoperative diagnosis rate was 50%, with one case not even diagnosed during surgery. CONCLUSION: Persistent urachal remnants can present at any age, with a variety of clinical manifestations. Abdominal computed tomography is a reliable diagnostic tool, and additional diagnostic studies are not generally warranted. The early surgical treatment seems to be the best solution prior to the onset of complications that would expose patients to difficult surgical operations and protract hospitalization.
