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.
Diatrizoate Meglumine ; Fistula ; Humans ; Infant ; Infant, Newborn ; Meconium ; Parturition ; Physical Examination ; Pregnancy ; Ultrasonography ; Umbilical Cord ; Umbilicus ; Vitelline Duct ; Yolk Sac

Although Meckel's diverticulum is the most common vitellointestinal duct (VID) anomaly, patent vitellointestinal duct (PVID) is the most common symptomatic embryological defect. Patient may present with the anomaly itself or due to complications like intestinal obstruction secondary to volvulus, intussusception or adhesions. Prolapse occurs if the diverticulum is wide-mouthed enough to allow bowel to come out or due to increased intra-abdominal pressure like cry or cough. Bowel prolapse through PVID is rare and double prolapse of proximal as well as distal loop in a newborn is extremely rare. Omphalocele with prolapsing bowel through PVID as found in our index case is even rarer in literature. The pediatric surgeon should be familiar with these varied manifestations in the newborn because the prolapsed bowel can progress to gangrene and complications if not identified and operated upon early.
Cough ; Diverticulum ; Gangrene ; Hernia, Umbilical* ; Humans ; Ileum* ; Infant, Newborn ; Intestinal Obstruction ; Intestinal Volvulus ; Intussusception ; Meckel Diverticulum ; Prolapse* ; Vitelline Duct

No abstract available.
Pancreas* ; Vitelline Duct*

Meckel's diverticulum (MD) is a true congenital diverticulum that is remnant by incomplete obliteration of the omphalomesenteric duct. It is the most common congenital anomaly of the gastrointestinal tract, with an estimated prevalence of 2% (0.3% to 3% in autopsy studies). About 90% of MD occurs within 100 cm of the ileocecal valve. A primary malignant tumor arising within an MD is extremely uncommon. Malignancies are reported to account for only 0.5% to 3.2% of the complications. Carcinoids are the most common malignant tumors occurring in MD. Adenocarcinomas are extremely uncommon and very poor prognosis has been reported. We report a case of radiographically diagnosed chronic inflammatory mass caused by adenocarcinoma arising from MD in the ileum with malrotation of the midgut incidentally discovered at exploration.
Adenocarcinoma ; Autopsy ; Carcinoid Tumor ; Diverticulum ; Gastrointestinal Tract ; Ileocecal Valve ; Ileum ; Meckel Diverticulum ; Prevalence ; Prognosis ; Vitelline Duct

Humans ; Infant, Newborn ; Infant, Newborn, Diseases ; diagnostic imaging ; Male ; Ultrasonography ; Urachus ; abnormalities ; diagnostic imaging ; Vitelline Duct ; abnormalities ; diagnostic imaging

An umbilical polyp is a rare congenital lesion and it represents one of the developmental anomalies of omphalomesenteric duct remnants. Clinically, an umbilical polyp presents as a red, firm and round tumor with mucoid and sometimes bloody secretions. Umbilical polyps can be mistaken clinically for other umbilical disorders such as umbilical granulomas and granuloma pyogenicum. Hisopathologically, the umbilical polyp is usually composed of small intestinal mucosa or ectopic gastrointestinal mucosa. Herein, we report on two cases of umbilical polyps:one umbilical polyp was composed of small intestinal mucosa and the other consisted of gastric mucosa.
Gastric Mucosa ; Granuloma ; Granuloma, Pyogenic ; Intestinal Mucosa ; Mucous Membrane ; Polyps ; Vitelline Duct

A vitelline duct (VD) anomaly is a relatively common congenital abnormality of the umbilical area. The anomalies include patent vitelline duct (PVD), cyst, fistula or sinus. The incidence is approximately 2% of the populations, but development of symptoms is rare. Recently, we experienced two cases; PVD accompanied by a smallomphalocele and intestinal volvulus due to mesenteric band between Meckel's diverticulum and the mesentery. Thereafter,we evaluated the data of vitelline duct anomalies for 27 years. From 1980 to 2006, 18 cases of VD anomalies were reviewed based on the hospital records retrospectively. There were 15 boys and 3 girls and age ranged from 2 days to 15 years. Among the 18 cases, 15 cases were symptomatic and consisted of Meckel's diverticulum (10 cases), PVD (4 cases) and umbilical polyp (1 case). Three asymptomatic cases of Meckel's diverticulum were found incidentally were and were observed without resection. Ten cases of Meckel's diverticulum were presented with intestinal bleedings (4 cases), intestinal obstructions (5 cases) and perforation (1 case). Wedge resections and segmental resections of ileum were performed in 8 patients and 2 patients, respectively. Postoperative complications were adhesive ileus (1 case) and wound seroma (1 case). Small omphaloceles were accompanied in two of 4 PVD patients. There was 1 small omphalocele case which was accompanied by a prolapse of ileum. In summary, VD anomalies were more common in male and more than half of them were found in patients less than 1 year of age. PVD was diagnosed most frequently in neonates. Meckel's diverticulum presented with intestinal obstruction more frequently than bleeding.
Adhesives ; Child* ; Congenital Abnormalities ; Female ; Fistula ; Hemorrhage ; Hernia, Umbilical ; Hospital Records ; Humans ; Ileum ; Ileus ; Incidence ; Infant, Newborn ; Intestinal Obstruction ; Intestinal Volvulus ; Male ; Meckel Diverticulum ; Mesentery ; Polyps ; Postoperative Complications ; Prolapse ; Retrospective Studies ; Seroma ; Umbilicus ; Vitelline Duct* ; Vitellins* ; Wounds and Injuries

Meckel's diverticulum is the most common congenital anomaly that results from an incomplete obliteration of omphalomesenteric duct. But only 10% of Meckel's diverticulums are symptomatic. The most common presentation in children is painless rectal bleeding, while intestinal obstruction is more common in adults. Obstruction with a Meckel's diverticulum is usually attributed to intussusception, volvulus, inflammatory adhesion, or an internal hernia. Author's experienced multi-directionally rotated Meckel's diverticulum causes intestinal obstruction with gangrenous change in a child and removed successfully with laparoscopic assistance. To our knowledge, this appears to be a first case report of a torsion of Meckel's diverticulum associated with intestinal obstruction in Korea, which was treated by laparoscopic procedure.
Adult ; Child ; Hemorrhage ; Hernia ; Humans ; Intestinal Obstruction* ; Intestinal Volvulus ; Intussusception ; Korea ; Laparoscopy ; Meckel Diverticulum* ; Vitelline Duct

An umbilical omphalomesenteric duct polyp arises from remnants of the omphalomesenteric duct, which connects the midgut to the Yolk sac of the embryo and is closed completely at 7 weeks. Persistence of the omphalomesenteric duct shows various clinical manifestations of embryologic anomalies such as umbilical enteric fistula, Meckel's diverticulum or vitelline cysts. In particular, the umbilical omphalomesenteric duct polyp should be clinically discerned from persistent granulation tissue or pyogenic granuloma and attention should be given to external openings with discharge, which can be suggestive of underlying anomalies. We herein report an case of an umbilical omphalomesenteric duct polyp in a 10-year-old male who had no underlying anomalies.
Child ; Embryonic Structures ; Fistula ; Granulation Tissue ; Granuloma, Pyogenic ; Humans ; Male ; Meckel Diverticulum ; Polyps* ; Vitelline Duct* ; Vitellins ; Yolk Sac

PURPOSE: To establish the proper approach and management of an urachal anomaly in children. MATERIALS AND METHODS: We retrospectively reviewed the medical records and imaging studies of 33 children (21 boys, 12 girls) treated for an urachal anomaly over a ten-year period. RESULTS: Twenty-four patients were equally diagnosed with either an urachal sinus or urachal cyst; the other nine patients were confirmed to have a patent urachus. Umbilical discharge (14 patients) and umbilical granuloma (9 patients) were the most common presentations. The 12 patients with an urachal sinus underwent ultrasonography (USG) (10; diagnostic), 2 fistulography (all; diagnostic). Those with an urachal cyst underwent either USG (6/12; diagnostic), computed tomography (CT) (3; diagnostic), fistulography (2; diagnostic), or magnetic resonance imaging (MRI) (1; diagnostic). One subject was affected by acute appendicitis, which was confirmed by CT. Of the 9 children with patent urachus, 7 underwent USG (all; diagnostic); exploration without further imaging studies was performed on the remaining 2 subjects. Surgical excision was performed in 30 patients. Omphalomesenteric duct or Meckel's diverticulum were incidental findings, which were simultaneously repaired. Conservative treatment was successful in only 3 patients. CONCLUSIONS: Urachal anomalies in children mainly manifest as umbilical discharges and umbilical granuloma, but may present non-specific symptoms in some cases. USG is a useful method for diagnosis, but other imaging modalities can be useful to establish the differential diagnosis. A limited number of children with urachal anomalies, mainly presenting with an umbilical discharge, can be managed conservatively. However, complete surgical excision of the lesion, with the possible associated anomalies, should be the basic scheme for children with urachal anomalies.
Appendicitis ; Child* ; Diagnosis ; Diagnosis, Differential ; Granuloma ; Humans ; Incidental Findings ; Magnetic Resonance Imaging ; Meckel Diverticulum ; Medical Records ; Retrospective Studies ; Ultrasonography ; Urachal Cyst ; Urachus ; Vitelline Duct