Urachal Cyst, Meckel’s Diverticulum and Band, and Urachus

A 4-year old boy presented with pain abdomen, bilious vomiting and constipation for three days. On examination, abdomen was distended and tender. X-ray abdomen revealed multiple air-fluid levels suggestive of intestinal obstruction. Ultrasonography abdomen revealed dilated bowel loops with minimal free fluid in peritoneal cavity. On exploration, there was a band causing obstruction of terminal ileum which was released. Band was arising from Meckel’s diverticulum which was connected to a cyst at umbilicus. On further exploration, the cyst was connected to urachus which was patent (Fig.1). There was no communication between bladder and urachus, cyst and urachus, Meckel's diverticulum and the cyst. Resection of Meckel’s diverticulum with ileum and end to end ileo-ileal anastomosis was done. Urachus and cyst were also excised. Patient recovered well postoperatively. Histopathology confirmed urachal cyst, urachus, and Meckel’s diverticulum.