Complete evagination of a patent vitellointestinal duct and adjacent ileal limbs from an omphalocele sac: an extreme presentation

Abstract

Vitellointestinal duct (VID) anomalies have been described extensively in the literature. However, an everted VID with prolapse of ileum arising from an omphalocele is rare, and its appearance at birth can be alarming and can present a diagnostic challenge. We describe a baby born to a teenage diabetic mother who was noted to have a strange exophytic mass arising from the abdominal wall. Antenatal scans had revealed multiple other malformations but not an omphalocele. He was operated on early, and the diagnosis of a patent VID with prolapse of the ileum arising from an omphalocele was only confirmed intraoperatively. The duct was resected, the ileum closed primarily and primary closure of the abdominal wall was performed without tension. He recovered well postoperatively. A brief review of similar cases is included.

Persistent omphalomesenteric duct in an infant with trisomy 21

“…Typically, in the majority of reported POMD cases, it presents similarly to our case, with faecal umbilical discharge 5–22. However, in more extreme cases, it has presented as an intestinal prolapse through the umbilical cord, and more subtly as a hernia in a single case 23–34. In some cases, it has presented as prolapsed intestines which have become obstructed in the umbilical cord 35–38.…”

“…Isolated POMD also has no recurrent associations with any antenatal health conditions. Some POMD cases have occasionally presented concurrently with other conditions, including six cases with omphalocele, one case of omphalocele and oesophageal atresia, one case of jejunoileal atresia, one case of exomphalos, four cases of patent urachus and one case of peromelia and amelia 28–33 42 49–54…”