Abstract
The urachal cyst is a rare clinical entity of a urachal remnant. It is usually asymptomatic but can present with haematuria, tumour, urachal stone and infection. We present a case of a 63-year-old lady with a body mass index (BMI) of 49 who presented with a painful swelling in the umbilical region associated with an umbilical hernia. An ultrasound and computed tomography (CT) scan showed a suspected herniation of an umbilical remnant cyst through a paraumbilical defect. Laparoscopy confirmed the urachal cyst of 3 cm in size with a band connected with the cyst down to the urinary bladder associated with a 3-cm paraumbilical hernia. We removed the cyst and repaired the hernia laparoscopically uneventfully, after which her recovery was perfect. Radiological and laparoscopic pictures have not been reported in the English literature before. Although this condition is very rare, we suggest that it should be considered in the differential diagnosis of painful paraumbilical swelling. CT scanning and laparoscopy seems to be valuable, especially in obese patients.
This is a preview of subscription content, log in via an institution to check access.
References
Hohenfellner R, Fitzpatrick J, McAninch JW (2005) Advanced urologic surgery, vol 3. Blackwell Publishing, London
Mesrobian HG, Zacharias A, Balcom AH, Cohen RD (1997) Ten years of experience with isolated urachal anomalies in children. J Urol 158:1316–1318
Cilento BG Jr, Bauer SB, Retik AB, Peters CA, Atala A (1998) Urachal anomalies: defining the best diagnostic modality. Urology 52:120–122
Yiee JH, Garcia N, Baker LA, Barber R, Snodgrass WT, Wilcox DT (2007) A diagnostic algorithm for urachal anomalies. J Pediatr Urol 3(6):500–504
Little DC, Shah SR, St Peter SD, Calkins CM, Murphy JP, Gatti JM et al (2005) Urachal anomalies in children: the vanishing relevance of the preoperative voiding cystourethrogram. J Pediatr Surg 40:1874–1876
Blichert-Toft M, Nielsen OV (1971) Diseases of the urachus simulating intra-abdominal disorders. Am J Surg 122:123–128
Efthimiou I, Charalampos M, Kazoulis S, Xirakis S, Spiros V, Christoulakis I (2008) Urachal carcinoma presenting with chronic mucusuria: a case report. Cases J 1(1):288
Seo IY, Han DY, Oh SJ, Rim JS (2008) Laparoscopic excision of a urachal cyst containing large stones in an adult. Yonsei Med J 49(5):869–871
Herman TE, Shackelford GD (1995) Pyourachus: CT manifestations. J Comput Assist Tomogr 19(3):440–443
Pagava AZ, Gavrilenko BG, Chervonnyĭ IuA, Vovk VM (1994) Suppurative urachal cyst simulating strangulated umbilical hernia. Khirurgiia (Mosk) 12:57–58
Stone NN, Garden RJ, Weber H (1995) Laparoscopic excision of a urachal cyst. Urology 45(1):161–164
Siegel JF, Winfield HN, Valderrama E, Smith AD (1994) Laparoscopic excision of urachal cyst. J Urol 151(6):1631–1633
Cadeddu JA, Boyle KE, Fabrizio MD, Schulam PG, Kavoussi LR (2000) Laparoscopic management of urachal cysts in adulthood. J Urol 164:1526–1528
Khurana S, Borzi PA (2002) Laparoscopic management of complicated urachal disease in children. J Urol 168:1526–1528
Cutting CW, Hindley RG, Poulsen J (2005) Laparoscopic management of complicated urachal remnants. BJU Int 96:1416–1421
McCollum MO, MacNeily AE, Blair GK (2003) Surgical implications of urachal remnants: presentation and management. J Pediatr Surg 38:798–803
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Gregory, G.C., Vijay, R., Ligaj, M. et al. Laparoscopic management of urachal cyst associated with umbilical hernia. Hernia 15, 93–95 (2011). https://doi.org/10.1007/s10029-009-0618-7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10029-009-0618-7