Surgical treatment of patent omphalomesenteric duct

Abstract

Omphalomesenteric duct (OMD) persistence in infants is a rare congenital malformation of the gut, with an incidence of about 2% of the population [1,2]. It usually has a difficult diagnosis, presenting as different skin related conditions or abdominal symptoms. This article reports two cases of total persistence of the OMD and reviews the surgical management of those lesions. Case one reports an one moth-old infant brought to hospital with persistence of the umbilical cord, with no response to topical treatment that later started draining feces from the umbilical chord. Case two reports a three-day-old male newborn that manifested a granuloma like lesion on the umbilical scar with no improvement with topical treatment. A Fistulography showed the persistence of the OMD in both cases. Both infants had a similar surgical approach, with an abdominal incision was made around the lesion on the abdominal wall. Identification of the fistula trajectory, followed by resection of the bowel segment that contains the fistulae and a formation of a termino-terminal anastomosis. OMD persistence and related malformations are rare conditions, presenting different and life threatening symptoms. They must be considered a differential diagnose for pediatric surgeons and pediatricians and surgical correction is recognized as the main treatment.