Overview
Urachal sinus infection occurs when remnants of the urachus become infected, often presenting as an abscess or cyst with symptoms like abdominal pain, fever, and localized swelling 1.Diagnosis
Clinical Presentation: Intermittent abdominal pain, fever, dysuria, and umbilical swelling 1.
Imaging: Ultrasound is crucial for identifying abscesses and cysts related to infected urachal remnants 1.
Surgical Confirmation: May be necessary for definitive diagnosis and treatment, especially in cases involving lithiasis 2.Management
Antibiotics: Initial treatment with appropriate antibiotics to cover common pathogens 1.
Abscess Drainage: Ultrasound-guided interventional radiology for abscess drainage 1.
Surgical Excision: Removal of the urachal cyst or remnant following resolution of infection 1.Special Populations
Pediatrics: Urachal sinus infections are notable in pediatric patients presenting with recurrent abdominal pain 1.
Comorbidities: Consider in patients with recurrent nephrolithiasis, as urachal lithiasis may coexist 2.Key Recommendations
Consider urachal sinus infection in the differential diagnosis of acute abdominal pain and recurrent symptoms in pediatric patients (Evidence: Moderate 1).
Utilize ultrasound for initial imaging to diagnose abscesses or cysts associated with infected urachal remnants (Evidence: Moderate 1).
Employ interventional radiology for guided drainage of abscesses in conjunction with antibiotic therapy (Evidence: Weak 1).
Plan surgical excision of the urachal remnant following successful resolution of infection (Evidence: Expert opinion 1).References
1 Yusuf S, Wassef AC, Schlesinger A. An Infected Urachal Cyst in a 4-Year-Old Girl Presenting with Recurrent Abdominal Pain. The Journal of emergency medicine 2019. link
2 Naroznik K, Kościolek E. A case of lithiasis of a persistent urachus. European urology 1977. link