Arenas-Márquez H, Hernández-Zúñiga JF, Barrera-Zepeda LM, Flores-Márquez MR, Chávez-Pérez R

Language: Spanish
References: 0
Page: 379-384
PDF size: 169.28 Kb.

ABSTRACT

Background: the urachal cyst is a rare pathology in the adult patient and in general is asymptomatic. The goal of this presentation is to learn of the errors.
Clinical Case: a 22 year old female with clinical diagnosis of acute appendicitis was taken to surgical management. Laparoscopy confirmed the diagnosis. Laparoscopic appendectomy was performed uneventfully. Four weeks in the postoperative period the patient developed reddening and softening in the left surgical wound which was a trocar incision. The initial diagnosis was a granuloma which was removed surgically twice. A fistulogram and abdominal CT scan were negative. Finally, we decided to perform a laparatomy trought the same incision and we found an infected urachal cyst, which was excised. A retrospective analysis of the laparoscopic appendectomy shows the urachal cyst and the perforation by the trocars.
Conclusion: an inadecuate process in the laparoscopic vision, in the diagnosis and technical errors were the cause of this chain of errors and a major temporal damage to this patient. An optimal laparoscopy had been detected the urachal cyst and the simultaneously treatment of the two pathologies simultaneously. An adequate trocar placement had not perforated the urachal cyst and therefore had not postoperative symptoms. Finnally open appendectomy could have avoided this chain of errors.