Infected urachal cyst presenting as acute abdomen – a case report

Urachal cysts are rare congenital anomalies arising from incomplete obliteration of the urachus, an embryological connection between the bladder and umbilicus. This report describes a 33-year-old man who presented with acute abdominal pain, constipation, and umbilical discharge. Diagnostic imaging, particularly computed tomography scans, revealed a thick-walled, fluid-filled cystic lesion adjacent to the umbilicus, indicative of an infected urachal cyst without evidence of bowel involvement. Diagnosing urachal anomalies in adults remains challenging due to their rarity and nonspecific clinical presentation, emphasizing the importance of imaging for accurate identification and targeted surgical intervention. The patient underwent successful surgical excision with drainage of the associated umbilical sinus and abscess, achieving satisfactory postoperative recovery. This case highlights the necessity of clinician awareness and prompt management of urachal cysts to prevent serious complications, such as persistent infection, abscess formation, or malignant transformation.