Abstract
A 65-year-old woman visited our department complaining of pain and purulent discharge in the umbilical region. Abdominal computed tomography (CT) showed a mass that continued from the navel to the bladder, suggesting a urachal abscess ; part of the boundary with the stomach wall was indistinct. Cystoscopy revealed edematous changes in the posterior wall of the bladder, with findings consistent with a urachal abscess. She was therefore diagnosed with a urachal abscess and underwent surgery. The urachal abscess adhered to the greater omentum and anterior wall of the stomach, and she underwent a urachectomy and concomitant partial resection of the greater omentum, stomach, and bladder. Tissue findings revealed infiltration of inflammatory cells continuing from the gastric mucosa to the abscess. Her course was favorable, and she was discharged on postoperative day 13. The present case had a prior history of being conservatively treated for gastric ulcer penetration three years before the present surgery, and there were no findings of urachal abscess in the imaging findings at that time. Later, the gastric ulcer was refractory, and abdominal CT performed one year earlier showed findings of a suspected urachal abscess in contact with the stomach wall. This report describes a case in which it appears that a gastric ulcer penetrated to the urachal remnant and formed an abscess.
