Patent Urachus with Patent Vitellointestinal Duct: A Rare Simultaneous Occurrence

Area of Science:

• Pediatric Surgery
• Developmental Biology
• Congenital Anomalies

Background:

• Umbilical anomalies are common congenital conditions.
• Simultaneous occurrence of multiple umbilical anomalies is rare.
• Patent urachus and patent vitellointestinal duct present unique diagnostic and surgical challenges.

Purpose of the Study:

• To report a rare case of coexisting patent urachus and patent vitellointestinal duct in an infant.
• To describe the diagnostic and surgical management of these combined anomalies.
• To emphasize critical surgical considerations in this anatomical region.

Main Methods:

• Voiding cystourethrogram to diagnose patent urachus.
• Surgical exploration for diagnosis and management.
• Resection and anastomosis for patent vitellointestinal duct.
• Urachal excision.
• Histopathological examination for confirmation.

Main Results:

• A patent urachus and a patent vitellointestinal duct were identified in the infant.
• Successful surgical resection and anastomosis of the vitellointestinal duct and excision of the urachus were performed.
• Histopathology confirmed intestinal epithelium lining the vitellointestinal duct remnant and a fibrous urachal remnant.
• Omphalo-mesenteric vessels identified between the anomalies.

Conclusions:

• Congenital anomalies of the umbilicus, including patent urachus and patent vitellointestinal duct, can coexist.
• Prompt diagnosis and surgical intervention are crucial for favorable outcomes.
• Awareness of the anatomical relationship of omphalo-mesenteric vessels is vital to prevent intraoperative bleeding.