Patent Omphalomesenteric Duct Research Articles

Various Clinical Manifestation of Omphalomesenteric Duct Remnant in a Child: A Case Report

Omphalomesenteric duct (OMD) remnant is a condition in which the omphalomesenteric duct fails to obliterate completely or partially. Failure in this step can produce various patterns, such as a vitelline cyst, umbilical sinus, polyp, Meckel’s diverticulum, and patent OMD. Various clinical manifestations of OMD rarely occur in one patient. We present the case of omphalomesenteric duct remnant, manifested as anterior wall abdominal mass, intraperitoneal hemorrhage, and obstructive ileus. Case report: A four-year-old girl was referred to our hospital with obstructive ileus and abdominal wall mass on the left lower quadrant. Contrast-enhanced abdominal computed tomography (CT) scan found an irregular cystic mass in the abdominal cavity that adheres to the anterior wall of the abdomen and bowel structure with a fluid-solid level without enhancement. Further medical history was taken and found a history of intermittent watery umbilical discharge that appears three times in 2 years after birth. Omphalomesenteric duct remnant was suspected, then proceed to exploratory laparotomy. We found intraperitoneal hemorrhage and 5x4 centimeters frail mass adhering to the anterior wall of the abdomen on the left side of the umbilicus. Histopathological examination confirmed intestinal tissue, suggesting remnants of the omphalomesenteric duct and pancreatic tissue with a chronic inflammatory pattern. Diagnosing omphalomesenteric duct remnant could be challenging and should be considered a differential diagnosis of obstructive ileus, particularly if persistent umbilical discharges are also present. On the other hand, early diagnosis and appropriate management of persistent umbilical discharge could prevent a greater outcome.

Successful Management of the Omphalomesenteric Fistula: About Three Case Reports

The omphalomesenteric duct is an embryologic connection between the midgut and yolk sac, which typically disappears at the 5th to 7th week of gestation. Failure of the obliteration process can lead to omphalomesenteric duct remnants. It usually has a difficult diagnosis, manifested by a variety of cutaneous signs, such as an umbilical mass, granulation tissue, or discharge. This article reports three cases of total persistence of the OMD and reviews the surgical management of those lesions. The first case reports a 6-day-old boy with a patent omphalomesenteric duct fistula opening to the umbilicus presenting with feces sprouting from the umbilical stump. The second one reports a one-month-old infant brought to the hospital with umbilical granuloma, with no response to topical treatment that later started draining feces from the umbilical cord. The third one reports a three-day-old male newborn that manifested a granuloma-like lesion on the umbilical scar with no improvement with topical treatment. A simple catheterization with a relation catheter was performed in all cases showing drainage of a bilious secretion. they were then diagnosed with a persistence of the Vitelline Duct. All infants had a similar surgical approach, with an abdominal elective incision 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 terminal-terminal anastomosis.

Ileal prolapse through patent omphalomesenteric duct in a two year-old boy: a case report

BackgroundPatent omphalomesenteric duct is one of the birth defects included in the spectrum of vitelline duct abnormalities. It is a rare anomaly with estimated prevalence of 0.13–0.2% in the general population. The most common presentation of patent vitelline duct is yellowish or mucoid type umbilical discharge which is usually noted in neonatal age or infancy. The main stay of diagnosis is clinical and outcome is favorable as long as timely surgical correction is offered. Here we present a 2 years old male child who presented with ileal prolapse through patent vitelline duct which is an exceptional mode of presentation of this pathology.Case presentation2 years old Ethiopian male child who was noticed to have umbilical discharge since early infancy presented with protrusion of pinkish mass per the umbilicus of 4 h duration. He had no signs and symptoms of bowel obstruction. Abdominal examination revealed a prolapsed bowel which was viable via the umbilicus which was about 6 cm long. Otherwise, he had no abdominal tenderness or rigidity. He was explored with a smiley incision just above the umbilicus. The prolapsed bowel was reduced gently to the abdominal cavity. The tract of the Patent vitelline duct was identified and completely resected along with a wedge of ileum at its base. Primary repair of the ileal end where the tract was inserted was done in two layers and abdomen was closed in layers. The child had smooth post op course and was discharged on the 4th post-operative day.ConclusionProlapse of a bowel through the umbilicus is unusual presentation of a rare anomaly namely patent vitelline duct. This presentation warrants early surgical intervention before bowel ischemia issues. Hence, all clinicians dealing with children should be aware of this rare pathology so that urgent surgical management can be offered.

Y-shaped ileal prolapse through a patent omphalomesenteric duct: A case report

Y-shaped ileal prolapse through a patent omphalomesenteric duct: A case report

Omphalocele with intestinal prolapse through a patent omphalomesenteric duct: A case report

Omphalocele with intestinal prolapse through a patent omphalomesenteric duct: A case report

A Newborn with Patent Omphalomesenteric Duct with Fecaloid Umbilical Drainage

A Newborn with Patent Omphalomesenteric Duct with Fecaloid Umbilical Drainage

VERY RARE COMBINATION OF PATENT VITELLOINTESTINAL DUCT WITH PATENT URACHUS

Introduction - The vitelline duct is the embryological narrow channel connecting the yolk sac with the intestine. During the foetal life, vitelline duct tends to obliterates itself till to disappear. The partial failure of this obliteration can lead to the development of a duct, a ligament, or a diverticulum known as a Meckel's diverticulum. A Patent omphalomesenteric duct occurs because of the complete lack of vitelline duct.[3] The urachus is an embryological remnant of the allantois. Between the fourth and fth month of gestation, the foetal bladder tends to descend gradually and its apical portion creates the urachus. The urachus obliterates itself, becoming the median umbilical ligament. Its persistence after intrauterine life can manifest as urachal remnants. A patent urachus is because of complete lack of obliteration of urachus [1,3]. The incidence of these anomalies PU was 1-2 per 10000 while PVD is 1 in 5000 to 8000 deliveries [1,3,5]. The association of both anomalies is very rare [7]. Case discussion- A 12-years-old male presented with complaints of pain in abdomen, multiple episodes of vomiting. Patient was tachycardiac with tenderness in right iliac fossa with palpable lump with ultrasonography suggestive of perforated appendix with lump formation and was managed conservatively and asked for interval appendicectomy with CECT abdomen. CECT was suggestive of normal and compressible appendix with infected urachal cyst. But after 4weeks patient had similar complaints hence posted for emergency operation with McBurney's incision not by midline incision to avoid injury to urachal cyst. Intra operative ndings-1) patent Vitello intestinal duct 2) patent urachus 3)15cc pus discharge near umbilical end of urachus 4) normal appendix and small bowel. Resection of Vitello intestinal duct and urachus with ileoileal anastomosis done and specimen sent for histopathology which was suggestive of patent vitello intestinal duct with changes of gangrene. The Patent Vitello Conclusionintestinal duct with patent urachus is very rarely seen in combination and its diagnosis may be missed preoperatively and should be kept as a possibility in patients with patent urachus with or without infection

Patent Omphalomesenteric Duct with Hemorrhagic Cyst with Urachus: Rare Case and Review of Literature

Patent Omphalomesenteric Duct with Hemorrhagic Cyst with Urachus: Rare Case and Review of Literature

Ectopic pancreas, gastric, duodenal and colonic tissue in a case of persistent umbilical discharge: Report of two patients with review of literature

One of the typical complaints in the pediatric population is umbilical discharge. Among the congenital causes, remnants of omphalomesenteric duct or patent urachus are often detected. On a few occasions, multiple types of ectopic tissue are present. We describe histopathologic findings of two cases reported recently at our center as pediatric umbilical lesions with associated ectopic tissue. Histopathology of the excised mass confirmed the patent omphalomesenteric duct with ectopic gastric, duodenal, and colonic mucosa and pancreatic tissue in two patients with the clinical presentation of umbilical discharge. There were no associated congenital anomalies in these patients. The presence of multiple ectopic gastrointestinal mucosa and pancreas in the umbilical mass is unusual. Herein, we report these cases because of its rarity, multiple ectopic tissues, and reviewing the literature of the reported cases of multiple ectopic tissues.

Patent omphalomesenteric duct in a newborn; a rare finding and presentation

The omphalomesenteric duct is an embryologic structure connecting the yolk sac with the developing fetus. Normally it involutes but sometimes the duct persists, which is most commonly found as a Meckel's diverticulum. Meckel's diverticulum typically presents in pediatric patients under 10 years of age as rectal bleeding or melena. Other complications range from obstruction, perforation, or inflammation. Here we present a neonate that initially presented with discharge from his umbilicus that progressed to drainage of stool. Imaging and workup prior was unremarkable. Surgical resection revealed the presence of a Meckel's enterocutaneous fistula to the umbilicus.

Patent Omphalomesenteric Duct

Patent Omphalomesenteric Duct

Fistula between a patent omphalomesenteric duct and a ruptured omphalocele sac in a neonate

This case report serves to document a rare case of a neonate who presented to the NICU with a patent omphalomesenteric duct (OMD) connected to the top of a ruptured omphalocele sac. Initial evaluation of the neonate in-utero led to the diagnosis of gastroschisis due to the presence of free-floating intestines on ultrasound. However, a ruptured omphalocele sac was discovered grossly upon delivery. Additionally, intestines were found in the midline of the abdomen, a common characteristic of omphaloceles. Therefore, the diagnosis was modified from gastroschisis to ruptured omphalocele. Further gross examination revealed a patent omphalomesenteric duct forming a fistula to the top of the ruptured omphalocele sac. After the appropriate workup and necessary procedures, the neonate had only one bowel movement over 2.5 weeks and was intolerant of food, raising suspicion for an intestinal atresia. Evaluation revealed a type 1 intestinal atresia distal to the patent OMD and omphalocele sac. The atresia was initially masked by bowel inflammation in the neonate at birth. Resection of the atretic bowel led to appropriate bowel movements and increased food intake. The neonate was eventually discharged in good health. • A patent omphalomesenteric duct has been observed to form a fistula with the top of an omphalocele sac in a neonate in-utero. • Ruptured omphalocele should be on the differential when in-utero ultrasound reveals free-floating intestines. • In neonates, intestinal atresia can initially be masked by inflammatory states from other complications.

Surgical treatment of patent omphalomesenteric duct

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.

Intestinal Prolapse Through Patent Omphalomesenteric Duct in a Neonate

Ileal evisceration through a patent omphalomesenteric duct is a rare neonatal surgical emergency. We present images of this condition highlighting the clinical presentation and treatment.

A Case of a Patent Omphalomesenteric Duct Presenting with Meconium Discharge from the Umbilicus

The omphalomesenteric duct is a link between the primitive midgut and the yolk sac. Normally, the duct obliterates around 6 weeks of gestation, yet varying degrees of incomplete obliteration can take place in 1%–4% of infants. This study described the case of a newborn with a patent omphalomesenteric duct remnant fistula identified at birth with meconium in the umbilical cord. At birth, the infant presented meconium staining and meconium discharged within the umbilical cord. Physical examination and other examinations showed no other specific findings. The omphalomesenteric duct fistula was confirmed through the imaging study (abdominal ultrasonography, gastrografin enema). A surgery was carried out where the remnant was resected. The patient did well and was discharged soon after without complication. Key words: Patent omphalomesenteric duct; Meconium; Umbilical cord

Associated patent urachus and patent omphalo–mesenteric duct in children

The objective of this article is to review the literature on a very rare association such as patent urachus and a patent omphalo–mesenteric duct in children. Partial or total failure of the obliteration of urachus gives rise to various anomalies, which can be diagnosed both in childhood and in adulthood. The omphalo–mesenteric duct remnants are the most common anomalies of the gastro-intestinal tract, often asymptomatic. The association of patent urachus and a patent omphalo–mesenteric duct in children is very rare. A computer-assisted (PubMed and Google Scholar) search of the pediatric literature to identify all cases of patent urachus and a patent omphalo–mesenteric duct association was performed. We found only eleven cases of the association of patent urachus and a patent omphalo– mesenteric duct in the pediatric literature. All cases except one were males. When reported, all children affected were full term. The clinical sign reported was umbilical spillage. In all cases was reported a lack of healing of the umbilical stump with different clinical pictures, except two cases. Treatments reported were application of silver nitrate, antibiotic cream, povidone iodine, and application of salves and plasters. Various diagnostic examinations were performed. In none of these patients was the possible association with PU and POMD suspected, but it was evidenced only during the surgical excision. The surgical approach was laparotomy in all cases. The association of patent urachus and a patent omphalo–mesenteric duct in children is very rare approached in all cases by laparotomy. This review underlines the importance of evaluating any persisting umbilical lesions without delay when conventional pharmacological therapy fails. Keywords: omphalo–mesenteric duct, patent omphalo–mesenteric duct, patent urachus, remnants, urachus

Axial Torsion of Meckel's Diverticulum Causing Small Bowel Obstruction in Adult: A Case Report

Meckel’s diverticulum (MD) is the most common congenital anomaly of the gastrointestinal tract that occurs in 2–3% of the population (1). The MD results from incomplete obliteration of the proximal most portion of the omphalomesenteric duct within 5 to 7 weeks of fetal development (2). Gastrointestinal bleeding due to ectopic gastric mucosa of MD causing ileal peptic ulceration is the most common complication in childhood. In adults, the more common complication is bowel obstruction caused by either intussusception or small bowel volvulus around a fibrotic band or patent omphalomesenteric duct anchored to the anterior abdominal wall. Other common complications include acute inflammation leading to perforation and hemorrhage. More rare complications include perforation of MD with foreign bodies, vesicodiverticular fistulae, strangulation in Littre’s hernia, or primary neoplasms. Torsion of MD, one of the rarest complications, is the result of axial twisting around its base (3). Pre-operative diagnosis of MD as a cause of small bowel obstruction is difficult, because the diagnosis can be made only if the diverticulum is delineated at the site of obstruction. In many cases, computed tomography (CT) features are similar to those of small bowel obstruction secondary to postoperative adhesions. Imaging features and risk factors of small bowel obstruction secondary to MD suggest the diagnosis. Herein, we reported a rare case of MD with axial torsion; furthermore, we briefly reviewed the relevant literature. Axial Torsion of Meckel’s Diverticulum Causing Small Bowel Obstruction in Adult: A Case Report 성인에서 발생한 멕켈 게실의 급성 염전에 의한 소장 폐색: 증례 보고

Patent omphalomesenteric duct opening into the vermiform appendix

Introduction: Persistent omphalomesenteric duct anomalies are very rare the world over. these anomalies are in a spectrum and present in various forms, ranging from the infamous Meckel’s diverticulum to a fibrous non-patent connection between the umbilicus and the distal ileum, to a patent connection between the umbilicus and the intestine, the patent omphalomesenteric duct. case report: A twomonth-old female child who was born with a membrane-covered umbilical mass which after sometime, became two swellings with intestinal epithelial covering and fistulous openings. At surgical exploration, she was discovered to have a patent omphalomesenteric duct which opened into the appendix, as well as intestinal malrotation abnormality. conclusion: the occurrence of patent omphalomesenteric duct opening into the vermiform appendix is a rare occurrence and there should be high index of suspicion when there is failure of healing of the umbilical stump and there is discharge of intestinal contents via the umbilicus.

Fistule omphalo-mésentérique compliquée : à propos d’une nouvelle observation

Omphalomesenteric fistula is an exceptional congenital anomaly related to complete persistence of the omphalomesenteric duct. Diagnostis is based on clinical and fistulographic findings. Even though complications are rare, treatment of patent omphalo-mesenteric must be precocious. We report a rare observation of patent omphalo-mesenteric duct and discuss the pathogenesis, clinical and radiological findings of this pathology.

Evisceration of Small Bowel After Cauterization of an Umbilical Mass

The omphalomesenteric duct (OMD), a temporary structure essential to fetal development, normally involutes completely by week 8 or 9 of gestation. On occasion, the OMD persists, the clinical presentations of which vary widely. We describe a case of a 6-week-old male with a patent OMD remnant that was initially treated as an umbilical granuloma, which then potentially allowed for prolapse of the small bowel through the umbilical ring. The patient required resection of the incarcerated bowel but had an otherwise uneventful and complete recovery.