Omphalomesenteric duct resection using an intraumbilical round incision or a transumbilical vertical incision: report of two cases

We report our experience with two patients who underwent omphalomesenteric duct resection: one for a patent omphalomesenteric duct and the other for a Meckel diverticulum connected to the umbilicus by a fibrous cord. We used an intraumbilical round incision and a transumbilical vertical incision, respectively. The first patient was a neonate with a patent omphalomesenteric duct who appeared to have a small stoma after ligature of the umbilical cord. Contrast media, injected through a catheter inserted into the stoma, entered the lumen of the small bowel. The second patient was an infant with a Meckel diverticulum connected to the umbilicus by a fibrous cord. After bloody stool was noted, nuclear imaging using 99m technetium pertechnetate revealed a small, round area of intense tracer activity in the midabdomen, suggesting the presence of ectopic gastric mucosa. Using either an intraumbilical or a transumbilical incision is safe and provides good cosmesis.

Inverted Proximal Ileal Loop Prolapse with Ileal Rupture through a Patent Omphalomesenteric Duct: A Rare Case

BACKGROUND: Prolapse of the small intestine through the umbilicus is indeed a rare presentation and is the most significant complication of the patent omphalomesenteric duct which requires pediatric surgical emergency due to its significant increase of mortality. To date, it is less than twenty cases of this presentation have been reported in medical literature. We are reporting a case of the same in an infant presenting with it on 1st week after he was delivered, but was followed by ileal rupture as well. CASE PRESENTATION: We present a case of a patent omphalomesenteric duct with ileal prolapse and ileal rupture as its complication. It is a case of a 1-year-old infant with a history of unusual bleed-on-touch mass emerging from the anterior abdominal wall with absent umbilicus. Once his condition is stabilised, he underwent a reduction of the prolapsed bowel along with complete excision of the omphalomesenteric duct and restoration of the ileal continuity. Post-operatively he regained normal bowel function and resumed breastfeeding 5 days after surgery. CONCLUSION: This case is an important addition to the literature about patent omphalomesenteric duct with complications of inverted proximal ileal loop prolapse and ileal rupture.