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Urachal Remnant Small Bowel Obstruction: Report of Two Adult Cases

Khashayar Vaziri, MD, Todd A. Ponsky, MD, Jon C. White, MD, Bruce A. Orkin, MD
Volume: 98 Issue: 8 August, 2005

Abstract:

This report describes two separate cases of adult patients with intestinal obstruction caused by an urachal remnant. While reports of infected urachal cysts causing intra-abdominal pathology are not uncommon, intestinal obstruction caused by urachal remnants is exceedingly rare in the pediatric population and has never been described in adults. Both of these patients required surgical intervention with excision of the urachal remnant and subsequent resolution of the small bowel obstruction.


Key Points


* In the face of normal regression, urachal remnants can cause significant intra-abdominal pathology in adults.


* This report describes two adult cases of small bowel intestinal obstruction caused by normally regressed urachal remnants.


* Proper identification of an urachal remnant as the cause of small bowel intestinal obstruction and appropriate management is important in the treatment of this disease.

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References:

1. Bleichert-Toft M, Axelsson C. Urachal lesion associated with calculus formation causing intestinal obstruction. Scand J Urol Nephrol 1977;11:77–79.
 
2. Bleichert-Toft M, Mielsen OV. Disease of the urachus simulating intra-abdominal disorders. Am J Surg 1971;122:123–128.
 
3. Ward T, Saltzman E, Chiang S. Infected urachal remnants in the adult: case report and review. Clin Infect Dis 1993;16:26–29.
 
4. Dammert W, Currarino G. Mesourachus and colon obstruction. J Ped Surg 1983;18:308–310.
 
5. Haupt GJ, Keitel HK. Intestinal obstruction in a child with a peritonealized urachal treatment. J Pediatr 1960;57:741–743.
 
6. Cameron J, et al. Current Surgical Therapy. Seventh edition. Mosby Publishing, 2001, pp 122–128.
 

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