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Urachal-sigmoid fistula in an adult male
1Department of General Surgery, Blodgett-St. Mary's Hospitals, Grand Rapids, Michigan, USA.
Insights
Urachal cysts, rare anomalies from incomplete urachus closure, can form fistulas. This case details the second-ever urachal-colonic fistula, uniquely in a patient with a normal colon, offering new insights.
Area of Science:
- Urology
- Gastroenterology
- Medical Case Reports
Background:
- Urachal cysts are uncommon congenital anomalies, representing 38% of urachal abnormalities.
- Typically presenting in childhood, urachal cysts are rarely diagnosed in adults over 40.
- Urachal-colonic fistulas are exceedingly rare, with only one prior reported case linked to diverticulitis.
Observation:
- This report documents the second-ever case of an urachal-colonic fistula.
- Crucially, this is the first reported instance of such a fistula occurring in a patient with a healthy, normal colon.
- The patient's presentation and diagnostic journey are detailed.
Findings:
- The study details the pathophysiology and clinical management of urachal cysts.
- It highlights the rarity and unique presentation of urachal-colonic fistulas.
- The case contributes novel data on fistula formation without pre-existing colonic pathology.
Implications:
- This case expands the understanding of urachal cyst complications and fistula formation.
- It suggests that urachal-colonic fistulas can occur independently of colonic disease.
- The findings may inform diagnostic and management strategies for rare urachal anomalies.
Abstract:
Urachal cysts are unusual anomalies resulting from incomplete closure of the urachus. They comprise 38 per cent of urachal abnormalities. They present commonly in childhood, and there are only 20 reported cases of urachal cysts presenting in a person over the age of 40. Only one reported case appears of urachal-colonic fistula, and this was in the setting of colonic diverticulitis. This report presents the second reported case of urachal-colonic fistula and the first case of a fistula in a patient with a normal colon. The pathophysiology and management of urachal cyst are discussed.