Keywords
Differential Diagnosis
Acute abdomen
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Abstract
Objective: To identify clinical patterns and diagnostic challenges in the preoperative period of urachal cysts initially misdiagnosed as other abdominal pathologies. Methods: An integrative literature review was conducted using PubMed, LILACS, SciELO, Google Scholar, BVS, MEDLINE, and Cochrane databases, with the descriptors “urachal cyst,” “differential diagnosis,” and “acute abdomen.” Articles published between 2006 and 2025 focusing on differential diagnosis of urachal cysts in adults were included. Of the 52 articles identified, 18 met the inclusion criteria. Results: Urachal cysts were found in both sexes, with an average age of 25.8 years. The most common symptoms were abdominal pain (83.3%), fever (33.3%), and dysuria (27.8%). Frequent misdiagnoses included umbilical hernia, acute appendicitis, rectus abdominis abscess and bowel obstruction. Ultrasound was the main diagnostic method (77.8%), followed by computed tomography (44.4%) and magnetic resonance imaging (33.3%). The nonspecific clinical presentation contributed to initial diagnostic errors. Final considerations: Although rare, urachal cyst should be considered in young adults with abdominal pain and umbilical discharge. Imaging exams are essential for correct diagnosis, and minimally invasive surgery is recommended. Further high-quality studies on the topic are needed.
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