Ewha Med J.  2021 Jul;44(3):84-88. 10.12771/emj.2021.44.3.84.

Omphalomesenteric Fistula Presenting with Meconium Discharge from the Umbilicus

• Lee YH
• Lee KH
• Han JW
• Cho SJ

• KMID: 2518771
• DOI: http://doi.org/10.12771/emj.2021.44.3.84

Abstract

The omphalomesenteric duct is an embryologic connection between the midgut and yolk sac, which typically disappears at 5th to 7th week of gestation. Failure of the obliteration process can lead to omphalomesenteric duct remnants. We report a case of a neonate with a patent omphalomesenteric duct fistula opening to the umbilicus presenting with meconium sprouting from the umbilical stump. Segmental resection of the ileum and end to end anastomosis were conducted. The patient was discharged on the 8th postoperative day without any complications, and no abnormalities were observed at the outpatient clinic follow-up up to 5 months after surgery. Here we describe the case and a review of the literature.

Keyword

Vitelline duct; Fistula; Meckel diverticulum; Umbilicus; Infant; newborn

Figure

• 

  Fig. 1 The patient had umbilical hernia with meconium discharge from the umbilicus stump at admission. (B) Abdomen sonography shows mild umbilical hernia with underlying omphalomesenteric duct fistula connecting terminal ileum to umbilicus tip with opening. (C) On the 3rd day of hospitalization, the patient had fistulography performed. The radiograph with contrast injected into a patent omphalomesenteric duct demonstrates filling of the small intestine through the umbilical cord. (D) This is an intraoperative photo of the patent omphalomesenteric duct connected to the umbilical cord and small intestine (open arrow, umbilical stump; closed arrow, small bowel). Informed consent for publication of the clinical images was obtained from the patient.

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