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Unusual presentation of patent vitello intestinal duct with round worms emerging from the umbilicus
N Surendran1, R Kumar, A Nassir
1Paediatric Surgery Department, Sri Avittam Thirunal Hospital, Medical College, Kerala, India.
Insights
A rare case of a patent vitellointestinal duct (VID) in a child presented with round worms emerging from the umbilicus. This unique association of ascariasis and a patent VID has not been previously reported.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Medical Case Reports
Background:
- Patent vitellointestinal duct (VID) is a common congenital anomaly in children, typically presenting with umbilical discharge.
- Ascariasis (roundworm infestation) is highly prevalent in Indian children.
- The co-occurrence of these two conditions is exceptionally rare.
Observation:
- A 2-year-old boy presented with a unique clinical manifestation: roundworms exiting the umbilicus.
- This unusual presentation led to a provisional diagnosis of a patent VID.
- Diagnostic laparotomy was performed to confirm the underlying condition.
Findings:
- The laparotomy confirmed the presence of a patent vitellointestinal duct (VID).
- This case represents the first reported instance of a patent VID associated with ascariasis presenting with umbilical worm expulsion.
- The findings highlight an unusual clinical presentation of a common pediatric anomaly.
Implications:
- This case expands the spectrum of clinical presentations for patent VID.
- It underscores the importance of considering unusual associations in pediatric diagnostics, especially in regions with high parasitic prevalence.
- Further investigation into the pathomechanisms linking ascariasis and patent VID may be warranted.
Abstract:
Patient vitello intestinal duct (VID) is not an uncommon anomaly in children. It usually presents with fecal discharge from the umbilicus. Round worm infestation is very common in Indian children, but an association of patent VID and ascariasis, presenting as round worms emerging from the umbilicus, is unique and has not been previously reported in the literature. We present such a case in a 2-year-old boy who presented with a history of round worms coming out through the umbilicus. It was provisionally diagnosed to be a case of patent VID, which was proven correct on laparotomy.