Patent vitellointestinal duct with prolapse of inverted loop of small intestine: a case report

Prashant N Mohite,Ashok M Bhatnagar,Virsing P Hathila,Jitendra H Mistry

doi:10.1186/1752-1947-1-49

Abstract

A wide variety of anomalies may occur as a result of the vitellointestinal duct (VID) failing to obliterate completely. Most reports on symptomatic VID focus on Meckel's diverticulum, while other anomalies are given little attention. We report a case of a baby of five months who had an intestinal loop inverted through a patent VID. The inverted loop was reduced and ileostomy was done which was closed after 6 weeks.

Highlights

Anatomy The midgut enlarges rapidly during the first 5 weeks of gestation and becomes too large for the abdominal cavity; subsequently, it is herniated into the umbilical cord
The stem of the 'Y' shaped loop was protruding from umbilicus and fixed to the anterior abdominal wall
The outer surface of the emerging loop was firmly adherent to all the layers of the anterior abdominal wall

Summary

Background

Anatomy The midgut enlarges rapidly during the first 5 weeks of gestation and becomes too large for the abdominal cavity; subsequently, it is herniated into the umbilical cord. At approximately the 10th week of gestation, the midgut begins its return into the abdominal cavity This return occurs by a highly complex developmental process, and as a result, numerous anomalies of the bowel may ensue. The stem of the 'Y' shaped loop was protruding from umbilicus and fixed to the anterior abdominal wall. The outer surface of the emerging loop was firmly adherent to all the layers of the anterior abdominal wall. Two different non-adherent loops of small intestine were found entering the emerging carrot like mass (See Figure 3). After complete reduction (See Figure 6) a defect of 2 × 2 centimeters was found in the small intestine (See Figure 2) at the point of adherence with the abdominal wall suggesting its patency with external environment through the umbilicus. Patient condition was followed up for about 6 months with no reports of any complications

Discussion

Chang LS