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Unexpected finding of urachal remnant cyst. Tips for laparoscopic approach.
Int J Surg Case Rep. 2020; 77S:S139-S142.IJ

Abstract

INTRODUCTION

Incomplete obliteration of the urachal lumen could cause different types of anomalies and urachal cyst is the most common among these in the adult population. It is usually asymptomatic and may be an incidental finding during a surgical exploration for other reasons. However, it can be subject to complications.

PRESENTATION OF CASE

A 38-year-old female patient with history of worsening lower-quadrants abdominal pain, associated with fever and chills, presented to emergency room; clinical examination revealed a painful, tender, and fixed lump to the left inferior abdominal quadrant. Ultrasound reveled a left adnexal mass and, along the midline, between the adnexal mass, the bladder and the uterus, was evident a 3-cm unilocular cyst with regular walls and hypoechoic content. MRI confirmed the suspicion of a left tubo-ovarian abscess and suggested a diagnosis of urachal remnant for the smaller midline cyst. In this report, we describe the step-by-step laparoscopic management of the case, paying attention to "the tips and tricks" for urachal cyst excision.

DISCUSSION

The urachal cyst, which results from the accumulations of secretions in urachal remnant, presents as a single or multiple parietal abdominal mass, per se asymptomatic. However, this condition is not without risk and infection represents the most common complication. Ultrasound is very useful in the diagnostic phase. Today, the main approach has become laparoscopic excision, with particular attention to a radical removing of the mass, due to high recurrence rate and the risk of malignancy.

CONCLUSION

In our experience, laparoscopy represents an excellent diagnostic and therapeutic tool for urachal cyst, especially for patients with acute urgent conditions, doubtful clinical history, and no clear signs or symptoms.

Authors+Show Affiliations

Obstetrics and Gynecology, "Villa Sofia Cervello" Hospital, University of Palermo, Italy. Electronic address: ostetriciaginecologia@villasofia.it.General Surgery Unit, Catholic University of the Sacred Heart, Rome, Italy.Obstetrics and Gynecology, "Villa Sofia Cervello" Hospital, University of Palermo, Italy.Obstetrics and Gynecology, "Villa Sofia Cervello" Hospital, University of Palermo, Italy.Obstetrics and Gynecology, "Villa Sofia Cervello" Hospital, University of Palermo, Italy.Obstetrics and Gynecology, "Villa Sofia Cervello" Hospital, University of Palermo, Italy.Department of Science for Health Promotion and Mother to Child Care "G. D'Alessandro", University of Palermo, Italy.Department of Science for Health Promotion and Mother to Child Care "G. D'Alessandro", University of Palermo, Italy.Obstetrics and Gynecology, "Villa Sofia Cervello" Hospital, University of Palermo, Italy.

Pub Type(s)

Case Reports

Language

eng

PubMed ID

33039342

Citation

Calagna, Gloria, et al. "Unexpected Finding of Urachal Remnant Cyst. Tips for Laparoscopic Approach." International Journal of Surgery Case Reports, vol. 77S, 2020, pp. S139-S142.
Calagna G, Rotolo S, Catinella V, et al. Unexpected finding of urachal remnant cyst. Tips for laparoscopic approach. Int J Surg Case Rep. 2020;77S:S139-S142.
Calagna, G., Rotolo, S., Catinella, V., Maranto, M., Carlisi, B., Bisso, C., Venezia, R., Mangione, D., & Cucinella, G. (2020). Unexpected finding of urachal remnant cyst. Tips for laparoscopic approach. International Journal of Surgery Case Reports, 77S, S139-S142. https://doi.org/10.1016/j.ijscr.2020.09.013
Calagna G, et al. Unexpected Finding of Urachal Remnant Cyst. Tips for Laparoscopic Approach. Int J Surg Case Rep. 2020;77S:S139-S142. PubMed PMID: 33039342.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Unexpected finding of urachal remnant cyst. Tips for laparoscopic approach. AU - Calagna,Gloria, AU - Rotolo,Stefano, AU - Catinella,Valeria, AU - Maranto,Marianna, AU - Carlisi,Bruno, AU - Bisso,Chiara, AU - Venezia,Renato, AU - Mangione,Donatella, AU - Cucinella,Gaspare, Y1 - 2020/09/11/ PY - 2020/06/27/received PY - 2020/09/03/revised PY - 2020/09/03/accepted PY - 2020/10/12/pubmed PY - 2020/10/12/medline PY - 2020/10/11/entrez KW - Abdominal wall KW - Case report KW - Laparoscopy KW - Pelvic pain KW - Remnant cyst KW - Urachal cyst SP - S139 EP - S142 JF - International journal of surgery case reports JO - Int J Surg Case Rep VL - 77S N2 - INTRODUCTION: Incomplete obliteration of the urachal lumen could cause different types of anomalies and urachal cyst is the most common among these in the adult population. It is usually asymptomatic and may be an incidental finding during a surgical exploration for other reasons. However, it can be subject to complications. PRESENTATION OF CASE: A 38-year-old female patient with history of worsening lower-quadrants abdominal pain, associated with fever and chills, presented to emergency room; clinical examination revealed a painful, tender, and fixed lump to the left inferior abdominal quadrant. Ultrasound reveled a left adnexal mass and, along the midline, between the adnexal mass, the bladder and the uterus, was evident a 3-cm unilocular cyst with regular walls and hypoechoic content. MRI confirmed the suspicion of a left tubo-ovarian abscess and suggested a diagnosis of urachal remnant for the smaller midline cyst. In this report, we describe the step-by-step laparoscopic management of the case, paying attention to "the tips and tricks" for urachal cyst excision. DISCUSSION: The urachal cyst, which results from the accumulations of secretions in urachal remnant, presents as a single or multiple parietal abdominal mass, per se asymptomatic. However, this condition is not without risk and infection represents the most common complication. Ultrasound is very useful in the diagnostic phase. Today, the main approach has become laparoscopic excision, with particular attention to a radical removing of the mass, due to high recurrence rate and the risk of malignancy. CONCLUSION: In our experience, laparoscopy represents an excellent diagnostic and therapeutic tool for urachal cyst, especially for patients with acute urgent conditions, doubtful clinical history, and no clear signs or symptoms. SN - 2210-2612 UR - https://www.unboundmedicine.com/medline/citation/33039342/Unexpected_finding_of_urachal_remnant_cyst._Tips_for_laparoscopic_approach. L2 - https://linkinghub.elsevier.com/retrieve/pii/S2210-2612(20)30685-4 DB - PRIME DP - Unbound Medicine ER -