RESUMO
A patent urachus is one of the spectrums of congenital urachal anomalies. It has been termed as "urachal fistula" when the lumen of intra-embryonic portion of allantois persist abnormally. Persisting urachal fistula is a rare condition mostly diagnosed during childhood or in autopsies. Here we report a very rare case of urachal fistula of a young male. We present a case of 22 years male with intermittent periumbilical pain and sero-purulent discharge from umbilicus since birth. On examination sero-purulent discharging umbilical sinus with granuloma was present. Surgical excision of whole of the urachal fistulous tract was done with repair of bladder. Patient did well during post-operative period. Persisting urachal fistula in adult is rare entity and difficult to diagnose because of low incidence and non-specific symptoms. So a high index of suspicion is required in order to make the early diagnosis of urachal anomalies.
RESUMO
Objective To study the efficacy and superiority of laparoscopy for the treatment of urachal fistula.Methods From January 2003 to March 2007,15 patients with urachal fistula received resection of the urachus in our hospital by laparoscopy with three trocar technique.The urachus was resected by clipping both the ends with Hem-o-lok and then cutting by ultrasonic scalpel.Frozen section examination of the resected tissues were carried out during the surgery.Results All the operations were completed under a laparoscope without conversions to open surgery.The operation time ranged from 25 to 50 minutes(mean,30 minutes).The intraoperative blood loss was 10 to 20 ml.The patients were discharged form hospital 2 to 4 days after the operation(mean,3 days).Among our cases,12 achieved a mean of 25.3 months follow-up(2 to 50 months),during this period none of them developed infections,recurrence,or carcinomatous changes.Conclusions Laparoscopy is feasible for urachal fistula.The method is simple and minimal invasive with good cosmetic outcomes and results in quick recovery.