Intestinal obstruction caused by a clamped persistent omphalomesenteric duct in congenital hernia into the umbilical cord

1982 ◽

Vol 40 ◽

pp. 250-251

Author(s):

B. A. Clark ◽

T. Okagaki

Keyword(s):

Umbilical Cord ◽

Umbilical Vein ◽

Meckel’S Diverticulum ◽

Meckel's Diverticulum ◽

Columnar Epithelium ◽

Omphalomesenteric Duct ◽

Umbilical Arteries

Vestiges of the omphalomesenteric or vitello-intestinal duct and the pathologic implications attributed to these remnants have been treated in great detail by several investigators. Persistence of the omphalomesenteric duct is associated with such conditions as Meckel's diverticulum, umbilical fistula, mucosal polyps, and sinuses or cysts of the umbilicus. Remnants of the duct in the umbilical cord, although infrequent, are located outside of the triangle formed by the two umbilical arteries and the umbilical vein, are usually discontinuous and are often represented by a small lumen lined by cuboidal or columnar epithelium. This study will examine the ultrastructure of these cells.

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THE UMBILICAL POLYP, A REMNANT OF THE OMPHALOMESENTERIC DUCT

PEDIATRICS ◽

10.1542/peds.20.1.98 ◽

1957 ◽

Vol 20 (1) ◽

pp. 98-100

Author(s):

Stanley E. Crawford

Keyword(s):

Young Children ◽

Intestinal Obstruction ◽

Neonatal Period ◽

Meckel’S Diverticulum ◽

Meckel's Diverticulum ◽

Recent Case ◽

Early Age ◽

Review Of The Literature ◽

Omphalomesenteric Duct ◽

Umbilical Polyp

THE PURPOSE of this paper is to report a recent case of an umbilical polyp and intestinal obstruction during the neonatal period. Umbilical polyps are rare. When present, they may be associated with Meckel's diverticulum because both are remnants of the omphalomesenteric duct. The presence of the visible polyp may give an external clue to otherwise obscure intraabdominal symptoms. A review of the literature earlier than 1916 is well summarized in a book by Thomas Cullen. This unusual volume lists six cases of umbilical polyp accompanied by other pathologic complications of Meckel's diverticulum. This author stressed that in these cases it should be pointed out to either the patient or his parents that possible intra-abdominal duct remnants may, at any time, give rise to symptoms such as intestinal obstruction. Penberthy and Benson reported a 9-year-old male with an umbilical polyp which had been present since birth and was without discharge. This youngster died following operation for intestinal obstruction due to volvulus about the diverticulum and its fibrous connection with the umbilical polyp. These authors pleaded for early elective operations in these cases prior to such complications. Gross gave other reasons for observation, and exploration at a reasonably early age, if a Meckel's diverticulum is suspected. Peritonitis from a ruptured Meckel's diverticulum is peculiarly dangerous; in young children the protecting omentum is inadequate and the migrating nature of the anomaly adds to the danger. Fluid from perforation of a diverticulum is usually of greater volume than that found in appendiceal rupture and abscess.

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