Background: An infected urachal cyst is an uncommon finding in adults.
Aim: To report a case of a sigmoid- urachal- cutaneous fistula.
Case report: A 51 years old adult male presented with fecaloid leaking from rupture of an infected urachal cyst. Definitive management consisted of resection of the urachus with a bladder cuff, along with removal of the affected bowel segments.
Conclusion: Colo-urachal-cutaneous fistula is a rare condition; its management is rather complex.