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      Laparoscopic Excision of a Urachal Cyst Containing Large Stones in an Adult

      case-report

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          Abstract

          Stone-containing urachal cysts are extremely rare in adults. Here, we report the case of a 58-year-old man with a urachal cyst who had lower abdominal pain and urinary frequency. Abdominal ultrasonography and computed tomography showed hyperdense stones in the urachus. He was treated with a laparoscopic excision using a transperitoneal approach. The pathological diagnosis was an inflammed urachal cyst. This rare case illustrates an inflammed urachal cyst containing stones treated with laparoscopy.

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          Infected urachal cysts: a review of 10 cases.

          I L Goldman, A Caldamone, M W Gauderer … (1988)
          Disorders of urachal remnants are uncommon. While a urachal cyst usually is asymptomatic, infection may mimic a variety of acute intra-abdominal or pelvic processes. We describe 10 patients in 2 distinct age groups (the young child and the young adult) with an infected urachal cyst. The presenting symptoms and signs in most patients included dysuria, severe lower abdominal pain and fever. In 7 patients the correct preoperative diagnosis was made. Diagnoses at referral included Crohn's disease, bladder carcinoma and pelvic inflammatory disease. A single procedure was performed in 7 cases and a staged technique was used in 3. The differential diagnosis of acute abdominal and pelvic pain or a midline lower abdominal mass in the pediatric or young adult age group should include infection of a urachal remnant.
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            Acute presentation of infected urachal cysts: case report and review of diagnosis and therapeutic interventions.

            Jason W Allen, Jean Song, Francisca T Velcek (2004)
            Urachal remnants, although relatively rare, masquerade as a large number of diverse disorders leading to a high rate of misdiagnosis. A typical case is reported in which a 10-year-old boy presented to the Emergency Department twice before being incorrectly diagnosed with a pelvic or lower abdominal periappendiceal abscess. Definitive diagnosis and treatment of an infected urachal cyst were made intraoperatively. A review and discussion of urachal remnants is presented, and a diagnostic algorithm and treatment plan is offered for this entity.
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              Laparoscopic management of urachal remnants in adulthood.

              Kikuo Nutahara, TAKATSUGU OKEGAWA, Akihiro Odagane … (2006)
              The aim of this study was to investigate the outcome of laparoscopic excision of urachal remnants (LUR), and to compare the outcome with that of the traditional open excision of urachal remnants (OUR). Between February 2001 and December 2005, six patients with a mean age of 23.8 years who had a symptomatic urachal sinus underwent radical LUR. Using 12 mm and 5 mm ports, the caudal stump of the urachus was ligated with an absorbable clip and divided. The peritoneal and preperitoneal tissue between the medial umbilical ligaments was dissected free of the transversalis fascia. Dissection was carried out along the preperitoneal plane toward the umbilicus. The cephalic side of the lesion was ligated at the umbilicus with an endo-loop and divided. In addition, four patients who underwent a traditional OUR were included. Peri- and postoperative records were reviewed to assess morbidity, recovery, and outcome. The operative duration was not significantly shorter for the LUR group than the OUR group, but there was generally a reduction in blood loss (mean 16.5 vs 68.3 mL), an earlier resumption of eating (mean 1.3 vs 2.5 days), and a shorter hospital stay (mean 5.3 vs 10.5 days). There were no intraoperative complications in either the LUR or the OUR group. Mean follow up was 5 (range 4-12) months. There were no postoperative complications. The results suggest that LUR can be safely and satisfactorily performed in adulthood.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Yonsei Med J
                Journal ID (publisher-id): YMJ
                Title: Yonsei Medical Journal
                Publisher: Yonsei University College of Medicine
                ISSN (Print): 0513-5796
                ISSN (Electronic): 1976-2437
                Publication date (Print): 31 October 2008
                Publication date (Electronic): 31 October 2008
                Volume: 49
                Issue: 5
                Pages: 869-871
                Affiliations
                Department of Urology, Institution of Wonkwang Medical Science, Wonkwang University School of Medicine, Iksan, Korea.
                Author notes
                Reprint address: requests to Dr. Ill Young Seo, Department of Urology, Wonkwang University School of Medicine, 344-2 Shinyong-dong, Iksan, Jeonbuk 570-711, Korea. Tel: 82-63-850-1333, Fax: 82-63-842-1455, seraph@ 123456wonkwang.ac.kr
                Article
                DOI: 10.3349/ymj.2008.49.5.869
                PMC ID: 2615372
                PubMed ID: 18972612
                SO-VID: bcb18940-525b-4e24-8b0e-9c4bb50ff352
                Copyright © Copyright © 2008 The Yonsei University College of Medicine
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 23 February 2007
                Date accepted : 19 April 2007
                Categories
                Subject: Case Report

                ScienceOpen disciplines: Medicine
                Keywords: laparoscopy,stone,urachal cyst
                Data availability:
                ScienceOpen disciplines: Medicine
                Keywords: laparoscopy, stone, urachal cyst

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