Presentation
Recurrent urinary tract infection, lower abdominal pain, and fever.
Patient Data
There is an ill-defined cystic lesion with thick enhancing wall and gas content in the urinary bladder dome, it measures about 18 x 25 x 13 mm (AP.TRANS.CC). This cystic lesion is connected to the inferomedial aspect of the distal sigmoid colon via a fistulous track, measuring about 23 mm in length. There is diffuse enhancement of the adjacent soft tissue as well as diffuse thickening and hyperenhancement of the urinary bladder wall. Mild to moderate pelvic free fluid.
Features are consistent with infected urachal cyst with urachal-sigmoid fistula and secondary cystitis.
Incidental finding of retro-aortic left renal vein.
Case Discussion
Urachal-sigmoid fistula is a fistulous track between the urachal remnant and the sigmoid colon (with or without bowel disease).