Abstract

A 64-year-old man visited our hospital with a 2 weeks history of lower abdominal pain and palpable mass. Physical examination revealed a tender mass in the suprapubic area. Abdominal ultrasonography and abdominal computerized tomography of the patient showed a cystic mass and adhesion of the bowel with a foreign body which fortunately found out to be a fish bone. An urachal abscess was suspected, and we first drained the cystic mass and debrided the necrotic tissues. We then performed a complete resection of the urachal remnant, a fistulectomy, a partial resection of adhesive ileum and a partial resection of the bladder. Urachal abscess by a swallowed fish bone is rare, and it was only reported in Japan. A preoperative diagnosis with ultrasonography or CT scan may be helpful to evaluate patients and make a treatment plan.

• Keywords: Urachus, Abscess