A Rare Case of Sigmoid-Urachal Fistula in an Adult Male Resected Laparoscopically

Abstract

Fistulization involving both the sigmoid colon and urachus is exceedingly rare. While previous cases have often necessitated laparotomy due to the involvement of multiple organs, only one instance of successful laparoscopic surgery has been reported. Here, we present the second documented case of laparoscopic resection of a sigmoid-urachal fistula. A 46-year-old male presented to our hospital with complaints of umbilical pain and discharge, subsequently diagnosed via CT scan as pyourachus, and conservatively managed with antibiotics. Approximately 1 year and 7 months later, a cutaneous ulcer developed below the left side of the umbilicus, accompanied by fecal discharge. Further investigation revealed a fistulous connection between the sigmoid colon and residual urachus as the underlying pathology. Utilizing laparoscopic techniques, we performed en bloc resection of the urachus, dome of the bladder, and sigmoid colon. The patient experienced an uneventful post-operative recovery and was discharged after 9 days.