Omphalitis with Umbilical Abscess in an Adult with a Urachal Remnant

Omphalitis is an inflammation of the umbilicus and is seldom diagnosed in adults. It is even rarer when it results from an infection of the urachus, an embryological remnant that connects the umbilicus to the dome of the bladder. Patients with omphalitis present with erythema, edema, tenderness, and purulent discharge form the umbilical stump. Workup includes ultrasonography and CT scan of the abdomen and pelvis. Management consists of antibiotics and incision and drainage of the umbilical abscess, followed by surgical resection of the urachal remnant. In this article, we report a case of omphalitis complicated by umbilical abscess in a 20-year-old female with a urachal remnant.

Robotic Partial Cystectomy for Urachal Carcinoma: A Case Report and Review of the Literature

Urachal carcinoma is a very rare tumor, commonly found in the urachal remnant connecting the bladder dome to the umbilicus. Diagnosis is often challenging due to the location of the tumor and its late presentation. We hereby report the case of a 49-year-old female where the diagnosis of urachal carcinoma was made and a robotic partial cystectomy associated with en bloc resection of the umbilicus was performed. We aim to present the clinical aspects, presentation, and diagnosis of this rare entity along with a review of the literature.

Robot-assisted excision of urachal cyst: case report in a child

Background The urachus is an embryological structure of the urogenital sinus and allantoid that connects the allantois to the early bladder in fetal life and then remains as the median umbilical ligament connecting the umbilicus to the dome of the bladder. An early laparoscopic procedure could trigger a quiescent urachal remnant to become symptomatic, causing a lesion or infection either during carbon oxide contamination or insufflation or a periumbilical or suprapubic port placement. Case presentation A 15-year-old girl complaining of supra-pubic abdominal pain. About 2 months previously, she had undergone laparoscopic appendectomy for acute appendicitis, and early postoperative period was uneventful. She underwent a robotic-assisted excision of a urachal cyst. Conclusions It has been suggested that early laparoscopic procedures could trigger previously asymptomatic urachal remnants to become symptomatic. Robot-assisted excision of a urachal cyst is a safe, effective alternative to open surgery in children.

Management of an Infected Vesicourachal Diverticulum in a 42-Year-Old Woman

Urachal remnant anomalies are uncommon in adults and can be confused with a variety of clinical conditions when symptomatic or infected. Vesicourachal diverticulum is the rarest type, accounting for approximately 3% to 5% of congenital urachal anomalies. We report the case of a 42-year-old female patient, who presented to the emergency department with lower abdominal pain and a palpable abdominal mass. An infected vesicourachal diverticulum was diagnosed after imaging studies and was initially treated with intravenous antibiotic therapy and drainage of the urachal diverticulum to the urinary bladder through a JJ stent. Finally, the patient underwent open surgical excision of the urachal remnant. The postoperative course was uneventful, and the histopathological examination confirmed the diagnosis of vesicourachal diverticulum. We recommend drainage of an infected vesicourachal diverticulum through the bladder by JJ stent placement inside its lumen during cystoscopy, as an alternative to percutaneous drainage reported in the literature.