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Urachal Cyst Presenting with Abscess Formation

Case report The case is reported ofa 42-year-old man who presented with a one week history of lower abdominal pain, reddening around the umbilicus (see Figure 1), and a 3-day history of dysuria. He was treated for these symptoms by his general practitioner with amoxycillin and co-trimoxazole.There was no other history of note. Positive findings on examination were a temperature of 38°C, periumbilical erythema and hypogastric tenderness. Investigations showed a white cell count of 13.7x109/l in the presence of normal urine microscopy and renal function. An ultrasound ofthe lower abdomen revealed an 11x 5x 3 ern mass arising from the superior surface of the bladder and extending to the umbilicus. Appearances were consistent with an abscess occurring in a urachal remnant. The abscess was formally drained and packed. Culture of the pus obtained grew Staphylococcus aureus. The appropriate antibiotics were given systemically. One week later the wound was clean and was closed over a corrugated drain. Cystoscopywas simultaneously performed and showed