Congenital intestinal fistula with exomphalos minor

Abstract

Minor degrees of exomphalos have been known to be associated with vitellointestinal duct anomalies. The most frequent association is Meckel's diverticulum. It is unusual for a fistula to be communicating directly with the exomphalos sac. We report five neonates that presented with a fistula on the exomphalos sac over a 10-year period. The different variants of patent vitellointestinal duct in these cases have been discussed with a review of the literature.

Hernia of the Umbilical Cord and Associated Ileal Prolapse through a Patent Omphalomesenteric Duct: Prenatal Ultrasound and MRI Findings

“…The most common association is umbilical hernia [5,6] . It is quite unusual for there to be a fistula communicating directly with the surface of the hernia sac, and this type of abnormality is rarely seen in clinical practice [3,6,8] . An associated prolapse of the ileum through a patent omphalomesenteric duct is also extremely rare with only 8 cases [5][6][7][9][10][11][12] reported in the English literature ( table 1 ).…”

“…Omphalomesenteric duct anomalies occur in approximately 2% of live births resulting in various lesions including Meckel's diverticulum (most common), umbilical sinuses, fistulae, cysts, polyps, and bands [6] . Twenty percent of the cases with a patent omphalomesenteric duct are complicated by prolapse of the small bowel through the duct [5][6][7] .…”

“…The passage of meconium or gas through the umbilicus indicates a patent omphalomesenteric tract with a fistulous communication with the intestinal tract [6] . The most common association is umbilical hernia [5,6] . It is quite unusual for there to be a fistula communicating directly with the surface of the hernia sac, and this type of abnormality is rarely seen in clinical practice [3,6,8] .…”

“…Twenty percent of the cases with a patent omphalomesenteric duct are complicated by prolapse of the small bowel through the duct [5][6][7] . The passage of meconium or gas through the umbilicus indicates a patent omphalomesenteric tract with a fistulous communication with the intestinal tract [6] . The most common association is umbilical hernia [5,6] .…”

“…Between 7 and 10 weeks' gestation, the duct becomes cordlike and loses its attachment to the midgut; by 10 weeks' gestation, it disappears from the embryo entirely [5] . Minor degrees of omphaloceles have been known to be associated with omphalomesenteric duct anomalies [6] . Moreover, small bowel prolapse through an omphalomesenteric duct is a rare clinical manifestation [7] .…”