A 13-year-old male presented to the emergency room with severe abdominal pain in the suprapubic and infraumbilical regions for 12 hours.
The patient reported for 4 days voiding discomfort and pain in the same area that increased with voiding.
His previous history was normal.
The patient shows intense pain to abdominal palpation in the suprapuberal and infraumbilical regions, increased acute phase reactants and leukocytosis.
Abdominal ultrasound and CT were performed, which revealed a persistent uracal remnant over-infected with the presence of a localized collection immediately below the tapeworm.
The pH of the umbilical fluid (between 5 and 6) is measured, thus confirming that it is urine.
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Antibiotic and analgesic treatment was started, beginning with draining purulent material from the umbilical fistula.
Two months later urachal excision was performed laparoscopically, removing a 3-4 cm urachal tract. Postoperative course was uneventful.
