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Ernest H. Agatstein, MD; Bruce E. Stabile, MD

Arch Surg. 1984;119(11):1269-1273.

Abstract
• Acute bacterial peritonitis due to intraperitoneal perforation of an infected urachal cyst represents a potentially lethal complication of the rare anomalies of the fetal urachus. We report four cases of this disease, including what we believe is the first to have been correctly diagnosed prior to operation. All four patients underwent emergency laparotomy and curative excision of the urachal remnant. Review of our four cases plus seven previously reported cases disclosed the perforated urachal cyst to be predominantly a disease of young males who initially have acute peritonitis but often without specific indication of a urachal anomaly. Bacteriologic examination has identified a wide variety of infecting organisms. Umbilical sinography or abdominal ultrasonography may allow accurate preoperative diagnosis. Broad-spectrum antibiotic coverage and laparotomy are indicated and excision of the entire urachal remnant is consistently curative.

(Arch Surg 1984;119:1269-1273)

Author Affiliations
From the Department of Surgery, UCLA School of Medicine (Drs Agatstein and Stabile) and the Surgical Service, Veterans Administration Medical Center (Dr Stabile), Los Angeles.

Footnotes
Accepted for publication July 3, 1984.

Read before the Annual Meeting of the Southern California Chapter of American College of Surgeons, Santa Barbara, Calif, Jan 28, 1984.

Reprint requests to Surgical Service (W112K), Veterans Administration Medical Center, Los Angeles, CA 90073 (Dr Stabile).

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