Rupture of an infected urachal cyst causing generalized peritonitis: a case report

A 68-year-old man visited our hospital with complaints of abdominal pain and fever. Physical examination disclosed findings consistent with acute abdomen. Computed tomographic (CT) scan revealed a 5 cm cystic mass contiguous with the dome of the bladder and fluid collection in the peritoneal cavity. Cystogram demonstrated deformity of the bladder and no communication between the mass and the bladder. A diagnosis of generalized peritonitis either due to the infected urachal cyst or ruptured bladder was made, and emergency exploratory laparotomy was carried out. Based upon findings consistent with an infected urachal cyst associated with its intraperitoneal perforation, resection of the entire urachal remnant including the dome of the bladder was performed. Pathologic examination showed an acutely inflammed urachal cyst and chronic inflammation of the bladder wall.