[The unusual case: a foreign body in the urachus].
BACKGROUND
In literature cystic tumours and carcinomas of the urachus are commonly described, also the secondary infection of a urachal cyst leading to an abscess is not unusual. But a foreign body penetrating after spontaneous perforation into an existing bland urachal cyst leading to an abscess is extremely rare and not described in literature. Although we made a thorough and extensive literature search we were not able to find a similar case.


METHODS
This report concerns a 38-year-old female patient suffering from diffuse pain in the lower abdomen as well as temperatures up to 39 degrees C referred for further diagnostics and treatment. Further examinations showed an infra-umbilical 6 x 6 cm cystic formation. A CT scan confirmed our suspicion of an inflammatory cystic finding in this area. A subsequent laparoscopic transabdominal excision of this region was -performed. The histological analysis showed a central abscess-forming urachal cyst. Centrally located and causal for the inflammatory process we found a 4-cm fishbone. Even after closer question-ing there was no anamnestic evidence of how this foreign body could have got there. A self-manipulation was resolutely and believably denied by the patient.


CONCLUSIONS
In our opinion this case is an absolute rarity due to the constellation of two extremely seldom components: a urachal cyst and a probable intestinal perforated foreign body.
Hatzinger
M
M
Urologische Abteilung Markuskrankenhaus Frankfurt. martin.hatzinger@fdk.info
Stastny
M
M
Wirsam
K
K
Sohn
M
M
D018784:Abdominal Abscess / Q000175:diagnosis* / Q000601:surgery; D000328:Adult; D002114:Calcinosis / Q000175:diagnosis / Q000601:surgery; D003937:Diagnosis, Differential; D005260:Female; D005547:Foreign Bodies / Q000175:diagnosis* / Q000601:surgery; D006801:Humans; D010535:Laparoscopy; D017699:Pelvic Pain / Q000209:etiology; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography; D014496:Urachal Cyst / Q000175:diagnosis* / Q000601:surgery; D014497:Urachus