TREATMENT OF AN OPEN OMPHALOMESENTERIC DUCT IN NEWBORNS



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Abstract

This article describes two clinical cases of surgical treatment of children with an unobliterated bile duct. The first boy, aged 21 day, was admitted to the hospital with complaints of constant “wetness” in the umbilicus area and a lack of effect of conservative treatment. The fistulography showed communication with the iliac lumen what confirmed involution violation of the omphalomesenteric duct and the formation of complete umbilicus fistula. An unobliterated bile duct was incised and umbilical ring plasty with a surgical stapler was made under general anesthesia. The second child, aged 10 days, was transferred from a cardiosurgical hospital after the staged correction of a congenital heart defect. He had the intussusception of small intestine loops through the umbilical ring, with signs of ischemia. In anamnesis few days before, a yellow-green discharge from the umbilical wound was noted. The additional examination revealed that it was a complication of unobliterated complete omphalomesenteric fistula. Transumbilical incision and resection of intestinal necrotic area with further anastomosis were made; revision and sanitation of abdominal organs and layer-by-layer suturing of the wound were performed too. The postoperative course was uneventful. The described clinical cases demonstrate that primary care specialists (especially of non-surgical profile) have to be cautious about pathological processes in the umbilical region in newborns. If the conservative treatment is ineffective and in order to verify the diagnosis, consultation with a pediatric surgeon is recommended. If the X-ray contrast fistulography is indicated, it should be performed at a specialized hospital.

About the authors

M. G. Rekhviashvili

Morozov Children’s City Clinical Hospital

Author for correspondence.
Email: dr.rekhviashvili@yandex.ru
ORCID iD: 0000-0003-2256-6198
Россия

A. A. Yakovleva

Morozov Children’s City Clinical Hospital

Email: noemail@neicon.ru
ORCID iD: 0000-0002-4578-2099
Россия

A. Yu. Kruglyakov

Morozov Children’s City Clinical Hospital

Email: noemail@neicon.ru
ORCID iD: 0000-0001-5055-0885
Россия

K. P. Chusov

Morozov Children’s City Clinical Hospital

Email: noemail@neicon.ru
ORCID iD: 0000-0002-6490-8590
Россия

M. Yu. Kozlov

Morozov Children’s City Clinical Hospital

Email: noemail@neicon.ru
ORCID iD: 0000-0002-9797-640X
Россия

V. V. Syt'kov

Morozov Children’s City Clinical Hospital; A.I. Yevdokimov Moscow State University of Medicine and Dentistry

Email: noemail@neicon.ru
ORCID iD: 0000-0001-6152-5693
Россия

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