Conservative management of a urachal remnant perforation during laparoscopic ovarian cystectomy

Complications associated with persistent urachal remnant disease have been well documented in neonates and more recently in adults. These include laparoscopic perforation. The case has previously been made for conservative management of small symptomatic urachal remnants in young infants and also for conservative management of iatrogenic cystotomies in the absence of overt sepsis using assisted bladder drainage and prophylactic antibiotics. However, to our knowledge, there has been no recent case of successful conservative management of laparoscopically perforated urachal remnant in an adult. This case describes the incidental perforation of a suspected urachal remnant in an adult female which resulted in an infected anterior abdominal wall collection. The patient was treated with assisted bladder drainage and intravenous antibiotics. Evidence of healing was demonstrated 4 weeks later using a cystogram