JKSS Journal of the Korean Surgical Society pISSN 2233-7903ㆍeISSN 2093-0488 J Korean Surg Soc 2012;83:254-257 http://dx.doi.org/10.4174/jkss.2012.83.4.254 CASE REPORT adults complication. Key Words: Urachal cyst, Adult INTRODUCTION Urachal cyst presenting with huge abscess formation in 1 2 Sung Hwan Lee, Hyang Im Lee , Dong Gue Shin Department of Surgery, Migrant Worker’s Hospital, Seoul, Departments of 1Pathology and 2Surgery, Seoul Medical Center, Seoul, Korea Urachal disease, a disorder where embryonic remnant of the cloaca and the allantois present after birth as a midline fibrous cord, is usually detected in infancy and childhood. But urachal disease in adults is rare. We report a case of a huge abscess de- rived from a urachal cyst in an adult. A 52-year-old man presented with peri-umbilical distension and abdominal pain for 2 weeks. Ultrasonography and abdominal computed tomography scan demonstrated a huge abscess derived from the ab- dominal wall. After prompt incision and drainage, the remaining abscess cavity was removed completely under general anesthesia. Pathologic report was consistent with urachal duct cyst, and the patient was discharged in a week without CASE REPORT The urachus is a fibrous cord structure formed after the A 52-year-old man presented with weight loss of 10 kg obliteration of the urogenital sinus and allantois during with lethargy and periumbilical distension with erythema the embryologic process. Abnormal remnants of the ur- after picking his umbilicus with his finger. He also com- achus can present as patent urachus, vesicourachal diver- plained of decreased appetite and intermittent abdominal ticulum, urachal sinus or urachal cyst. Urachal abscess is pain localized to the periumbilical region for 2 weeks. an uncommon manifestation of urachal disease and rare in There was no personal history of any systemic diseases adults. We present one case of a huge urachal abscess in an and major operations. On physical examination, vital adult derived from a urachal cyst. signs were stable except rapid pulse rate of 110 beats/min. The abdomen was rigid and distended, and there was er- ythema around the umbilicus with tenderness and focal rigidity. Laboratory data revealed a white blood cell count of Received January 19, 2012, Revised May 17, 2012, Accepted May 31, 2012 Correspondence to: Dong Gue Shin Department of Surgery, Seoul Medical Center, 156 Sinnae-ro, Jungnang-gu, Seoul 131-130, Korea Tel: ＋82-2-2276-7871, Fax: ＋82-2-2276-7880, E-mail: shindonggue@naver.com cc Journal of the Korean Surgical Society is an Open Access Journal. All articles are distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Copyright © 2012, the Korean Surgical Society