Urachal remnant small bowel obstruction: report of two adult cases.(Case Report)

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 Words: intestinal obstruction, intra-abdominal pathology, small bowel, urachal remnant

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The urachus is a band of fibrous tissue extending from the apex of the bladder to the umbilicus. It is a remnant of an embryologic canal running from the fetal cloaca to the umbilicus. By 32 weeks, the urachus degenerates into a solid band of tissue called the median umbilical ligament. In 0.1 to 2.0% of the population, the urachus remains patent and may result in urine leaking from the umbilicus or infected urachal cysts. We have found that even in the face of normal regression, the urachal remnant may lead to complications. We report two patients with intestinal obstruction caused by an urachal remnant. …