An infected urachal cyst is a rare differential diagnosis for an acute abdomen in adult female: a case report


  • Ramesh Bettaiah Department of Gynaecological Endoscopy and Infertility, Dr Ramesh Hospital, Bangalore, Karnataka, India
  • Shraddha Neminath Kurkuri Department of Gynaecological Endoscopy and Infertility, Dr Ramesh Hospital, Bangalore, Karnataka, India
  • M. Chandramouli Department of Surgery, Dr Ramesh Hospital, Bangalore, Karnataka, India



Urachus, Urachal cyst, Abscess, Adult


An infected urachal cyst is one of a spectrum of presentations of urachal pathology, all of which are rare in adulthood. Patients tend to present in a heterogeneous fashion, making diagnosis difficult. A 45-year old lady presented with sudden onset of lower abdominal pain and fever since 10 days. There was tenderness and focal rigidity in the right iliac fossa. Abdominal ultrasonography revealed suprapubic collection with mixed echogenecity. On diagnostic laparoscopy; urachal abscess was confirmed and excised. Urachal disease is usually detected in infancy and childhood. Infection is the usual mode of presentation amongst adults otherwise the condition usually remains asymptomatic. Diagnosis is often made after exploratory laparotomy or laparoscopy. Ultimately, surgical intervention is the treatment of choice. Complete excision is important because malignant degeneration of the remnant is possible. In cases where a pre-operative diagnosis has been made, a staged approach with antibiotics followed by surgery has been recommended.


Risher WH, Sarda A, Bolton J. Urachal abnormalities in adults: the Ochsner experience. Southern Medical Journal. 1990;83:1036-9.

Begg RC. The urachus: its anatomy, histology and development. Journal of Anatomy. 1930;64:170-83.

Mesrobian HG, Zacharias A, Balcon AH, Cohen RD. Ten years of experience with isolated urachal anomalies in children. J Urol. 1997;158(3 Pt 2):1316-8.

Yiee JH, Garcia N, Baker LA, Barber R, Snodgross WT, Wilcox DT. A diagnostic algorithm for urachal anomalies. J Pediatr Urol. 2007;3:500-4.

Ekwueme KC, Parr NJ. Infected urachal cyst in an adult: a case report and review of the literature. Cases Journal. 2009;2:6422.

Yoo KH, Lee SJ, Chang SG. Treatment of infected urachal cysts. Yonsei Medical Journal. 2006;47:423-7.

Ueno T, Hashimoto H, Yokoyama H, Ito M, Kouda K. Urachal anomalies: ultrasonography and management. J Pediatr Surg. 2003;38:1203.

Beck AD, Gaudin JH, Bonhan GD. Carcinoma of urachus. Br J Urol. 1970;42:555-62.

Groot-Wassink T, Deo H, Charfare H, Foley R. Laparoscopic excision of the urachus. Surgical Endoscopy. 2000;14:680-1.






Case Reports