Omphalomesenteric Duct Cysts of the Umbilical Cord

Abstract

Three cases of omphalomesenteric (OM) duct cyst within the umbilical cord are presented and analyzed together with 6 previously reported cases. The embryology of the OM duct is reviewed, emphasizing those portions of the duct that may persist beyond early fetal life. Omphalomesenteric duct cysts are located at the proximal (fetal) end of the cord and range from 0.4-6.0 cm in diameter. They appear as cystically dilated "miniature" segments of the gastrointestinal tract and are lined by columnar epithelium resembling that of the gastric, small intestinal, or colonic mucosa; islands of pancreatic tissue may be associated with the cyst lining. The cysts have peripheral angiomatoid vascularity and the surface epithelium of the cord at one site tends to be hyperplastic. These lesions occur more often in males than in females and are unrelated to prematurity or to maternal age, race, or gravidity. They only rarely cause fetal morbidity or mortality but evidence is presented to suggest that they may on occasion be associated with potentially dangerous intraabdominal anomalies of the OM duct.

Umbilical Cord Cysts of Allantoic and Omphalomesenteric Remnants with Progressive Umbilical Cord Edema: A Case Report

“…Complete patency of the omphalomesenteric duct affects males eight times as often as females. There is no apparent association between omphalomesenteric remnant cysts and maternal age, race, gravity, or the incidence of prematurity [6] .…”

“…Such a case has not been reported previously. The omphalomesenteric duct, which is a communication between the developing embryonic gut and the yolk sac, is formed during the 3rd week of gestation and usually obliterated by the 7-16th week [6] . On the other hand, the allantoic duct, which is the intra-abdominal portion of the allantois from the bladder to the umbilicus, is formed during the 2nd week of gestation and usually obliterated by the 15th week [6] .…”

“…The omphalomesenteric duct, which is a communication between the developing embryonic gut and the yolk sac, is formed during the 3rd week of gestation and usually obliterated by the 7-16th week [6] . On the other hand, the allantoic duct, which is the intra-abdominal portion of the allantois from the bladder to the umbilicus, is formed during the 2nd week of gestation and usually obliterated by the 15th week [6] . Jauniaux et al [7] reported that microscopic evidence of embryonic remnants of the umbilical cord was found in 23% (231/1,000 cases), which were further divided into 63% allantoic remnants and 6% omphalomesenteric remnants.…”

“…It is true that most of the fetuses having umbilical cord cysts, regardless of true cysts or pseudocysts, could be delivered vaginally [17][18][19]23] . Although some of urachal or omphalomesenteric remnants were not detected prenatally, those fetuses were born by vaginal delivery without complications [6,8] . On the other hand, Bunch et al [20] reported a case having an umbilical cord cystic mass communicating with the bladder confirmed by MRI.…”

Persistierender Ductus omphaloentericus-Eine mögliche Ursache des blutenden Nabels

“…Selten enthält das Meckelsche Divertikel versprengtes Pankreasgewebe oder Magenschleimhaut. Beim Typ 3 können sich bis 6 cm grosse Dottergangzysten ausbilden [10]. Da dann beide Enden des Dotterganges nicht selten als fibröse Stränge das Abdomen durchqueren, kann es als Komplikation zur Strangulation oder zum Volvulus des Darmes kommen.…”