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Inverted Proximal Ileal Loop Prolapse with Ileal Rupture through a Patent Omphalomesenteric Duct: A Rare Case
Handayani Handayani1, Yamoguna Zega2, Tati Ziliwu1
1Department of Pediatrics, Gunungsitoli General Hospital, Nias, North Sumatera, Indonesia.
Insights
A rare case of infant intestinal prolapse due to a patent omphalomesenteric duct, complicated by ileal rupture, highlights the need for prompt surgical intervention in this pediatric emergency.
Area of Science:
- Pediatric Surgery
- Gastrointestinal Surgery
- Congenital Anomalies
Background:
- Patent omphalomesenteric duct is a rare congenital anomaly.
- Intestinal prolapse through the umbilicus is a significant complication, increasing mortality.
- Fewer than twenty cases of this presentation have been documented.
Observation:
- A 1-year-old infant presented with a bleed-on-touch mass from the anterior abdominal wall and absent umbilicus.
- The infant experienced ileal prolapse and subsequent ileal rupture.
- The condition required immediate pediatric surgical intervention.
Findings:
- Surgical reduction of prolapsed bowel and complete excision of the omphalomesenteric duct were performed.
- Restoration of ileal continuity was achieved.
- Post-operative recovery included normal bowel function and resumption of breastfeeding within 5 days.
Implications:
- This case adds to the limited literature on patent omphalomesenteric duct complications.
- Highlights the critical nature of inverted proximal ileal loop prolapse and ileal rupture.
- Emphasizes the importance of early diagnosis and surgical management in preventing life-threatening outcomes.
Background:
Prolapse of the small intestine through the umbilicus is indeed a rare presentation and is the most significant complication of the patent omphalomesenteric duct which requires pediatric surgical emergency due to its significant increase of mortality. To date, it is less than twenty cases of this presentation have been reported in medical literature. We are reporting a case of the same in an infant presenting with it on 1st week after he was delivered, but was followed by ileal rupture as well.
Case Presentation:
We present a case of a patent omphalomesenteric duct with ileal prolapse and ileal rupture as its complication. It is a case of a 1-year-old infant with a history of unusual bleed-on-touch mass emerging from the anterior abdominal wall with absent umbilicus. Once his condition is stabilised, he underwent a reduction of the prolapsed bowel along with complete excision of the omphalomesenteric duct and restoration of the ileal continuity. Post-operatively he regained normal bowel function and resumed breastfeeding 5 days after surgery.
Conclusion:
This case is an important addition to the literature about patent omphalomesenteric duct with complications of inverted proximal ileal loop prolapse and ileal rupture.
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