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Alqarni MA, Kutubkhana RH, Alhosami SM, Almutairi FA, Almutairi AM, Alqannad EM, Almansour MH, Alanazi AA, Althobaiti AM, Althobaiti ZF, Alshehri MA, Malki SZ, Alhasani HM, Alburi MA, Al-Hawaj F. Vesicourachal Diverticulum: A Rare Cause of Recurrent Urinary Tract Infections. Cureus 2021; 13:e20118. [PMID: 35003961 PMCID: PMC8723736 DOI: 10.7759/cureus.20118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/02/2021] [Indexed: 11/05/2022] Open
Abstract
Urinary tract infection is a common medical condition encountered in outpatient clinics and emergency departments. Recurrence of urinary tract infections is common. The recurrence can arise from behavioral, mechanical, and physiological factors. Urachal anomalies are very rare congenital clinical entities. We present the case of a 41-year-old woman who presented to the emergency department with dysuria, frequency, urgency, and incontinence. There was no history of fever or flank pain. Physical examination revealed no abnormalities. Initial laboratory markers were within the normal range. However, urinalysis findings showed numerous white blood cells and positive leukocyte esterase and nitrite. While these findings are suggestive of acute simple cystitis, the patient had a concerning history of recurrent urinary tract infections. The urology team advised performing an abdominal computed tomography scan to rule out any structural abnormalities. The patient underwent a computed tomography scan, which demonstrated the presence of a fluid-filled structure arising from the dome of the bladder and extending superiorly toward the umbilicus, representing a vesicourachal diverticulum. The patient underwent surgical resection after antibiotic therapy. The vesicourachal diverticulum is a very rare type of urinary tract anomalies. The case highlights the importance of considering congenital urachal anomalies in patients with recurrent urinary tract infections. A computed tomography scan can make the diagnosis of such anomalies with high accuracy.
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Affiliation(s)
| | | | | | - Faris A Almutairi
- College of Medicine, Ibn Sina National College for Medical Studies, Jeddah, SAU
| | - Amer M Almutairi
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | | | | | | | | | | | | | | | | | | | - Faisal Al-Hawaj
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, SAU
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Al Furaikh BF, Alzahrani NA, Alghamdi AA, AlBalawi MZ, Alghamdi FG, Alzahrani TA, Alghamdi MS, Alkhatib MI, Alshammari MA. Urachal Abscess: A Rare Etiology of Acute Abdominal Pain in Adults. Cureus 2021; 13:e18193. [PMID: 34707963 PMCID: PMC8534299 DOI: 10.7759/cureus.18193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/22/2021] [Indexed: 11/17/2022] Open
Abstract
Abdominal pain is a common cause of emergency department visits. It often poses a diagnostic challenge for physicians given the broad spectrum of its possible medical and surgical etiologies. We report the case of a 32-year-old man who presented to the emergency department with a complaint of lower abdominal pain for one week. Abdominal examination revealed suprapubic mass and tenderness. Laboratory investigation revealed elevated leukocyte count and inflammatory markers. An abdominal ultrasound examination showed a collection with poorly defined borders. Additionally, CT demonstrated a soft tissue mass adjacent to the anterior abdominal wall with an upward track to the umbilicus, conferring the diagnosis of a urachal abscess. The patient underwent successful management of the abscess with surgical excision. This case highlights the importance for clinicians to be aware of congenital urachal anomalies since early recognition of the urachal cyst is essential to determine the proper surgical management.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Malak A Alshammari
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, SAU
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Almas T, Khan MK, Fatima M, Nadeem F, Murad MF. Urachal Sinus Complicated by an Umbilical Abscess. Cureus 2020; 12:e9527. [PMID: 32905066 PMCID: PMC7466011 DOI: 10.7759/cureus.9527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
The urachal sinus is a vestigial remnant that ensues in the aftermath of incomplete obliteration of the embryonic urachus. Urachal sinuses often remain asymptomatic, being discovered incidentally in instances where they are complicated with a superimposed infection or abscess. Due to their rare occurrence in adults, urachal sinuses are rarely included in the list of differential diagnosis surrounding umbilical pain in adult patients. We hereby delineate a unique case of a urachal sinus in a 26-year-old male patient. Due to the presence of an abscess in a hirsute male, a presumptive diagnosis of an umbilical pilonidal sinus was suspected. However, further diagnostic workup divulged an unequivocal diagnosis of a urachal sinus complicated by an abscess formation.
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Affiliation(s)
- Talal Almas
- Internal Medicine, Royal College of Surgeons in Ireland, Dublin, IRL
| | - Muhammad Kashif Khan
- Surgical Oncology, Federal Government Poly Clinic (Post Graduate Medical Institute), Islamabad, PAK.,Surgical Oncology, Maroof International Hospital, Islamabad, PAK
| | - Mishal Fatima
- Obstetrics and Gynecology, Rawalpindi Medical University, Rawalpindi, PAK
| | - Faisal Nadeem
- General Surgery, Maroof International Hospital, Islamabad, PAK
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