Infected Urachal Cyst with Urethral Stricture Presenting as Acute Appendicitis: Case Report

Abstract

Abstract Introduction: Urachal anomalies are rare disorders of the urogenital tract, more commonly found in males, and sometimes they may masquerade as other diseases. We present a case of urachal cyst with urethral stricture which presented as acute appendicitis. Case presentation: A 22-year-old patient presented to our emergency department in shock, following a one-week history of pain in the lower right abdomen. The patient was initially diagnosed with acute appendicitis based on clinical examination, and a urology consultation was requested due to the inability to catheterize the patient. The patient also reported a history of dysuria and straining, with unsuccessful attempts at catheterization. Ultrasonography revealed the presence of free fluid in the peritoneum and grade III hydroureteronephrosis. During exploratory laparotomy, we discovered a urachal cyst that had no connection with the bladder. The urachal cyst was excised after performing a suprapubic cystostomy. Following conservative surgery for pus drainage and excision of the urachal cyst, further management in the form of urethroplasty was performed to address the urethral stricture. Conclusions: Urachal abnormalities are rare causes of abdominal pain. Obtaining a detailed patient history and maintaining a high index of suspicion is crucial for improving patient outcomes