PDF(Pubmed)
Abstract：
BACKGROUND: Patent 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.
METHODS: 2 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.
CONCLUSIONS: Prolapse 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.
METHODS: 2 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.
CONCLUSIONS: Prolapse 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.
摘要：
背景：脐肠管未闭是卵黄管异常谱中包括的出生缺陷之一。这是一种罕见的异常现象，在普通人群中的患病率估计为0.13-0.2％。卵黄管最常见的表现是淡黄色或粘液型脐带分泌物，通常在新生儿年龄或婴儿期出现。诊断的主要停留在临床上，只要及时提供手术矫正，结果是有利的。在这里，我们介绍了一个2岁的男性儿童，他通过专利卵黄管表现出回肠脱垂，这是该病理的一种特殊表现方式。
方法：2岁的埃塞俄比亚男童，自婴儿期早期以来被发现有脐带排出，每4小时的脐带出现粉红色肿块。他没有肠梗阻的体征和症状。腹部检查显示肠脱垂，可通过约6厘米长的脐带存活。否则,他没有腹部压痛或僵硬。他在肚脐上方有一个笑脸切口。将脱垂的肠轻轻地缩小到腹腔。确定了专利卵黄管的管道，并在其基部与回肠楔形一起完全切除。插入管道的回肠末端的初次修复分两层进行，腹部分层闭合。该孩子的术后课程顺利，并在术后第4天出院。
结论：通过脐肠脱垂是罕见的异常表现，即卵黄管未闭。此演示文稿需要在肠缺血问题之前进行早期手术干预。因此，所有与儿童打交道的临床医生都应该意识到这种罕见的病理，以便可以提供紧急的手术治疗。
方法：2岁的埃塞俄比亚男童，自婴儿期早期以来被发现有脐带排出，每4小时的脐带出现粉红色肿块。他没有肠梗阻的体征和症状。腹部检查显示肠脱垂，可通过约6厘米长的脐带存活。否则,他没有腹部压痛或僵硬。他在肚脐上方有一个笑脸切口。将脱垂的肠轻轻地缩小到腹腔。确定了专利卵黄管的管道，并在其基部与回肠楔形一起完全切除。插入管道的回肠末端的初次修复分两层进行，腹部分层闭合。该孩子的术后课程顺利，并在术后第4天出院。
结论：通过脐肠脱垂是罕见的异常表现，即卵黄管未闭。此演示文稿需要在肠缺血问题之前进行早期手术干预。因此，所有与儿童打交道的临床医生都应该意识到这种罕见的病理，以便可以提供紧急的手术治疗。
