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Rare spontaneous regression of patent omphalomesenteric duct after birth
  1. E Kurzbart1,
  2. M Zeitlin2,
  3. D Feigenbaum2,
  4. A Zaritzky2,
  5. Z Cohen3,
  6. A J Mares3
  1. 1Pediatric Surgery, The Barzilai Medical Center, Ashkelon, Israel; ednaverdi{at}yahoo.com
  2. 2Neonatal Unit, The Barzilai Medical Center, Ashkelon, Israel
  3. 3Department of Pediatric Surgery, Soroka Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Israel

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    The abdominal radiograph (fig 1) shows contrast material in the small bowel after injection through a fourth lumen found in the transected umbilical cord of an infant born at 28 weeks gestation (in vitro fertilisation), consistent with a patent omphalomesenteric duct.

    When the infant was 3 months old, the umbilical skin was completely closed leaving a 1.5 cm umbilical hernia. Exploratory surgery was performed. Neither patent omphalomesenteric duct nor its fibrous remnant were present.

    A Meckel's diverticulum was found 40 cm from the ileocaecal junction (fig 2). A Meckel's diverticulectomy was performed. The period after the operation was uneventful.

    Patent omphalomesenteric duct accounts for about 2% of omphalomesenteric duct malformations1 and should be suspected in the presence of an umbilical discharge, umbilical granuloma not responding to silver nitrate cauterisation, or in the presence of an additional non-vascular lumen in a transected umbilical cord. Prompt surgical repair minimises the risk of intestinal obstruction and prolapse of the ileum through the fistula. Only one similar case of spontaneous postnatal regression of a patent omphalomesenteric duct was found in the literature.2

       Figure 1
    Figure 1

    Abdominal radiograph after cannulation of the fourth lumen in the umbilical cord showing contrast material in the small bowel.

       Figure 2
    Figure 2

    Laparotomy revealed a Meckel's diverticulum adherent to the mesenterium without a mesodiverticular band.

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