A four-year-old boy with no history of interest presented with a four-day history of periumbilical and hypogastric abdominal pain of continuous type that improved with analgesia and was awakened at night.
During the previous 24 hours, she presented fever with a maximum temperature of 39.8 °C, constipation, dysuria in all myopathies, without macroscopic hematuria, or other respiratory or digestive symptoms.
On physical examination, only hypogastric abdominal pain in the midline and left iliac fossa with normal external genitalia and no inflammatory signs in the urethral meatus is noteworthy.
A urine reactive strip is performed which is normal and, when there is suspicion of an intra-abdominal infectious condition, an abdominal ultrasound is performed in the health center where there is a calcified tubular flow in the umbilical region, immediately below the abdominal wall.
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With these clinical data and 80% CT scan confirmed the suspicion that this could be a complicated urachal cyst, leading to the emergency department of the referral hospital where laboratory tests are performed, showing a white blood cell count of 866.80/ 733
The patient was admitted for intravenous antibiotic therapy and drainage was performed under ultrasound control, from which a dense, purulent and hemorrhagic material was obtained, from which the culture was isolated Morganella morganii, according to antibiotic treatment.
In a second time, surgery is performed allowing resection of the anomalous structure.
