BACKGROUND:

Malakoplakia is a disease related to the abnormal activity of the phagocytic function of the macrophages that usually affects the urinary and gastrointestinal tracts and is associated with chronic infections (50%) or immunosuppression (40%).

CLINICAL CASE:

A 44-year-old man came to the emergency service complaining of fever (39ºC) of 7-day progression, accompanied by dysuria and colicky, infraumbilical abdominal pain of 4/10 intensity, with a periumbilical mass and leukocytosis. Computed tomography urography identified a bladder storage defect and communication into the anterior abdominal wall. Treatment was transurethral resection of the bladder. The tumor was resected from the bladder dome and the anterior bladder wall, with the release of mucous material. The patient persisted with fever and abdominal pain in the postoperative period. Exploratory laparotomy revealed an abdominal tumor dependent on the bladder and the urachus, as well as reactive appendicitis. The histopathologic report stated malakoplakia of the bladder and urachus.

CONCLUSION:

This is the first case of urachal malakoplakia with an atypical presentation reported at the Hospital General Dr. Manuel Gea González.

        · resumen en Español     · texto en Español     · Español ( pdf )