Peritonitis caused by a purulent cyst of the urachus in a young woman

Urachal cysts are not exceptional and are observed more often in children. In adults, they may become infected and cause clinical symptoms associating subumbilical midabdominal pain, fever, guarding and leukocytosis. Intraperitoneal rupture is exceptional (21 published cases) and only 7 cases have involved adult female patients. The authors report the case of a 27-year old woman with peritonitis caused by rupture of a suppurated urachal cyst, 6 cm in diameter, for which diagnosis was established by perioperative ultrasound. The surgical procedure used consisted of total excision of the urachus, the umbilico-prevesical fascia and partial excision of the dome of the urinary bladder. Indeed, total excision is imperative because of the risk of malignant degeneration of this mass into an adenocarcinoma.