Giant abscessed urachal cyst in adult. Case report

Background: during gestation, the urachus represents the connection between the dome of the bladder and the allantoic duct. This infection occurs preferentially in young adults, advocating the haematogenous or lymphatic pathway as possible routes of transmission, while a cord or bladder origin may also occur. Is uncomund in adult life, and is only the 2%. Clinic case: thirty years male patient with a history of alcoholic hepatitis, diabetes mellitus type 2, chronic malnutrition, increased volume beginning with generalized abdominal pain, abdominal tumor of 20 for 15 cm, mobile, solid, without signs of peritoneal irritation. TC with presence of tumor probably dependent of bladder, apparently cystic. Exploratory laparotomy was found infected urachal cyst, draining purulent material 3,000 cc, partial resection of the anterior face, keeping the back by firm adherence to bowel loops. Evolving satisfactorily. Discussion: urachal abnormalities are rare, with male / female ratio of 2 / 1. Although urachal abscess is an infection confined to an enclosed space, definitive treatment should not be the simple incision and drainage, because the possibility of malignant transformation of urachal remnants. The definitive treatment should be considered complete excision of urachal cyst and when the infection is limited. Conclusion: the urachus cyst is a rare pathology and is a diferencial diagnosis for acute appendicitis and need to know this treatment.