Colourachal fistula in an adult presenting with feculent umbilical drainage.

摘要: A 26-year-old female presented with a 2-week history of fever, left lower abdominal pain and feculent drainage from the umbilicus. During previous month patient had also noticed increased urinary frequency but denied any hematuria, dysuria or pneumaturia. She no significant changes in bowel movements. medical conditions surgeries. Aside tenderness umbilical drainage, examination was unremarkable. Urine culture microscopic analysis were negative, while cultures taken fluid grew Escherichia coli. Abdominal computerized tomography (CT) revealed urachal remnant containing gas an adjacent inflammatory mass sigmoid diverticulitis (see figure). Cystoscopy demonstrated edematous at bladder dome obvious fistula. The placed on 6-week course levofloxacin metronidazole resolution pain, although persisted. underwent elective excision cuff en bloc colectomy primary end-to-end colonic anastomosis. Intraoperatively, abscess perforated fistulization to urachus. Pathological showed patent measuring 3 cm diameter, cystitis glandularis dome, colourachal Postoperative uneventful removal catheter day 11 complete symptoms.