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Prolapse of inverted ileal loops through a patent vitellointestinal duct

Ashish Pathak1, Nitin Agarwal2, Poonam Singh3

  • 1Department of Pediatrics, RD Gardi Medical College, Ujjain, Madhya Pradesh, India Department of Public Health Sciences, Global Health (IHCAR), Stockholm, Solna, Sweden Department of Women and Children's Health, International Maternal and Child Health Unit, Uppsala University, Uppsala, Sweden.

BMJ Case Reports
|October 24, 2015
PubMed

Insights

A prolapsed patent vitellointestinal duct (PVID) in an infant presented as a Y-shaped umbilical lesion. Surgical correction was successful, highlighting PVID as a common symptomatic omphalomesenteric duct anomaly.

Area of Science:

  • Pediatric Surgery
  • Congenital Anomalies
  • Gastrointestinal Surgery

Background:

  • The omphalomesenteric duct (vitellointestinal duct) normally obliterates in fetal development.
  • Failure of obliteration can lead to various congenital umbilical anomalies, including Meckel's diverticulum and patent vitellointestinal duct (PVID).
  • PVID is the most common symptomatic anomaly arising from the patent omphalomesenteric duct.

Observation:

  • A 2-month-old girl presented with a rapidly enlarging, polypoidal, Y-shaped umbilical lesion.
  • The lesion was reddish, prolapsed, and discharged gaseous and fecal matter.
  • Diagnosis was prolapsed inverted ileal loops through a patent vitellointestinal duct (PVID).

Findings:

  • The patient had no associated congenital anomalies.
  • Surgical management involved transumbilical exploration, wedge resection, and anastomosis.
  • The child tolerated the surgery well with an uneventful postoperative recovery.

Implications:

  • Prolapsed patent vitellointestinal duct (PVID) is a significant cause of symptomatic umbilical abnormalities in infants.
  • Prompt surgical intervention is crucial to prevent complications associated with PVID.
  • This case underscores the importance of recognizing and managing PVID in pediatric surgical practice.

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