TREATMENT OF AN OPEN OMPHALOMESENTERIC DUCT IN NEWBORNS



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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.

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M. Rekhviashvili

Morozov Children’s City Clinical Hospital

编辑信件的主要联系方式.
Email: dr.rekhviashvili@yandex.ru
ORCID iD: 0000-0003-2256-6198
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A. Yakovleva

Morozov Children’s City Clinical Hospital

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

Morozov Children’s City Clinical Hospital

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

Morozov Children’s City Clinical Hospital

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

Morozov Children’s City Clinical Hospital

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

  1. Поддубный И.В., Дьяконова Е.Ю., Исмаилов М.У., Трунов В.О., Махаду А.Р., Ярустовский П.М., Бекин А.С., Толстов К.Н. Лапароскопические операции при патологии дивертикула Меккеля. Детская хирургия. 2015; 19(5): 4-6.
  2. Козлов Ю.А., Новожилов В.А., Барадиева П.А., Разумовский А.Ю. Лапароскопическая техника резекции омфаломезентериального протока у новорожденных. Эндоскопическая хирургия. 2014; 20(6): 29-32.
  3. Solomon-Cohen E, Lapidoth M, Snast I, et al. Cutaneous presentations of omphalomesenteric duct remnant: A systematic review of the literature. J Am Acad Dermatol. 2019; 81(5): 1120-6.
  4. Bertozzi Mirko, Recchia Nicola, Di Cara Giuseppe, Riccioni Sara, Rinaldi Victoria Elisa, Esposito Susanna, Appignani Antonino. Ultrasonographic diagnosis and minimally invasive treatment of a patent urachus associated with a patent omphalomesenteric duct in a newborn. Medicine. 2017; 96 (30): 7087.
  5. Elebute E.A., Ransome-Kuti O. Patent vitello-intestinal duct with ileal prolapsed. Arch Surg. 1965; 91: 456-60.
  6. Davis R.M., Kehm R.W. Omphalocele with patent vitellointestinal duct and ileal prolapsed. Am J Surg. 1967; 113: 571-3.
  7. Lal M.M., Dhall J.C. Ileal prolapse through patent vitello-intestinal duct: a report of 3 cases with review of literature. Indian J Pediatr. 1976; 13: 571-3.
  8. Rohatgi M., Gorthi S.N. Omphalocele with patent omphalomesenteric duct and ileal prolapsed. ndian J Pediatr. 1984; 51: 119-23.
  9. Gvalani A.K., Acharya A.G., Rao R.V. Ileal prolapsed through a patent vitellointestinal. Indian Pr. 1985; 38: 629-32.
  10. Mohite P.N., Bhatnagar A.M., Hathila V.P. Patent vitellointestinal duct with prolapse of inverted loop of small intestine: a case report. J Med Case Rep. 2007; 1: 49.
  11. Zea M., Chana R., Anees A., Khan S. Inverted ileal prolapse through patent vitellointestinal duct: a case report. Internet J Pediatr Neonatol. 2009; 2013: 2.
  12. Agrawal S., Memon A. Patent vitellointestinal duct. BMJ Case Rep. 2010.
  13. Singh S., Pandey A., Ahmed I., Rawat J.D., Sharma A., Srivastava N.K. et al. Prolapse of bowel via patent vitello intestinal duct - a rare occurrence. Hernia. 2011; 15: 567-9.
  14. Pauleau G., Commandeur D., Andro C. Intestinal prolapse through a persistent omphalomesenteric duct causing small-bowel obstruction. S Afr J Surg. 2012; 50: 102-3.
  15. Patel R.V., Kumar H., Sinha C.K., Patricolo M. Neonatal prolapsed patent vitellointestinal duct. BMJ Case Rep. 2013.
  16. Kadian Y.S. Patent vitellointestinal duct with inverted ileal loop prolapse: a rare presentation. Onc Gas Hep Rep. 2015; 4: 95-7.
  17. Fariha Akil Fazal, James Muturi Ndungu, HumdunSaid, Josephat Njiru, FredKambuni. New-born born with patent vitellointestinal duct with prolapsed (intussusceptions) of proximal and distal ileal loop: A case presentation. Journal of Pediatric Surgery Case Reports. 2017; 20: 14-6.

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