Revista Mexicana de Cirugía Endoscópica

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>Journals >Revista Mexicana de Cirugía Endoscópica >Year 2009, Issue 1

Mussan CG Torres SC, Sánchez JG, García GMA, Pérez BR, Obregón MJ
Urachus remnant. Laparoscopic management
Rev Mex Cir Endoscop 2009; 10 (1)

Language: Español
References: 15
Page: 45-48
PDF: 164.32 Kb.

[Full text - PDF]


Introduction: The urachus is a vestigial fibrous cord derived from involution of the allantois that extends from the bladder apex to the umbilicus. Urachal remnant is a rare congenital anomaly, with an incidence of 1: 5000 in adults. The classic triad of the urachus pathology is umbilical secretion, abdominal pain and urinary symptoms. Traditional surgical management of benign urachal disease involves the radical excision of all anomalous tissue with or without a cuff of bladder tissue via the open approach.
Case presentation: Twenty-three year old, female patient who for the last four months has had a on and off evolution with transparent liquid leakage and afterwards purulent discharge in the umbilical scar, smelly, with hyperemia, accompanied with pain in the same region.
These episodes were treated by cleaning of the wound and antibiotics. Based on previous clinical elements, a diagnosis of urachal remnants was made and a surgical excision by laparoscopy was chosen. The patient evolved favorably and was discharged in 24 hours with no complications.
Discussion: Urachal remnants are estimated to exist in approximately 2% of adult persons, however, only few of these anomalies become symptomatic. Urachal sinus is the most frequent variant, found in 50-60% of cases. Urachal cyst is encountered in 20-40% of cases, leaving patent. Urachus the least common anomaly accounting for 15-20% of cases. Our case is thus a remainder that congenital disorders may occasionally be encountered in adult urology. The case further highlights that a non-invasive surgical approach such as laparoscopic technology is well feasible with the benefits of minimal invasive surgery.

Key words: Urachus remnant, laparoscopy, urachal cyst, urachal diverticulum, urachal sinus, omphalitis.

>Journals >Revista Mexicana de Cirugía Endoscópica >Year 2009, Issue 1
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