Persistent urachal duct in adults: case report and literature review
DOI:
https://doi.org/10.62407/pekqa974Keywords:
Persistent urachus, Congenital anomalies, Urachal fistula, Diagnostic imaging, Urachal surgery, chirurgie de l'ouraqueAbstract
Introduction: The urachus is a normal embryonic structure derived from the allantois and the cloaca that connects the bladder dome to the umbilicus. Normally, it becomes obliterated during fetal development, transforming into the median umbilical ligament (Ryan et al., 2023). Persistent urachal duct is a rare congenital anomaly in adults whose nonspecific clinical presentation makes early diagnosis difficult and often delays appropriate treatment. Case report: The case of a 26-year-old man is presented, with no significant medical history who presented with sharp umbilical pain (8/10), erythema, fever, and purulent discharge lasting eight days. Ultrasound revealed a 6-mL subcutaneous collection. After an initial surgical drainage without clinical improvement, a second ultrasound demonstrated a fistulous tract extending from the umbilicus to the hypogastrium. Surgical re-exploration confirmed a complete persistent urachus with communication between the umbilicus and the bladder apex. Complete resection of the duct and ligation of the vesical remnant were performed, with favorable postoperative recovery under antibiotic therapy. Clinical relevance: This case highlights the importance of considering urachal anomalies in the differential diagnosis of persistent umbilical drainage in adults, emphasizing the need for high clinical suspicion and precise imaging–surgical correlation.
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