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1.
BMJ Case Rep ; 17(5)2024 May 08.
Artigo em Inglês | MEDLINE | ID: mdl-38719262

RESUMO

We present the case of a term newborn with trisomy 21 who presented to the paediatric emergency department with periumbilical flare and green-brown discharge from a clamped umbilical cord, initially suspected to be omphalitis. However, it was noticed later, that when the infant strained or cried, a thick, bubbling and offensive green-brown discharge came out of the clamped umbilical cord with umbilical flatus. An ultrasound abdomen and umbilical cord confirmed the presence of a persistent omphalomesenteric duct (POMD). He was then transferred to the paediatric surgical unit. There, he underwent a laparotomy and surgical resection of the POMD and was discharged home 2 days later.


Assuntos
Síndrome de Down , Ducto Vitelino , Humanos , Síndrome de Down/complicações , Recém-Nascido , Ducto Vitelino/anormalidades , Ducto Vitelino/diagnóstico por imagem , Masculino , Cordão Umbilical/anormalidades , Cordão Umbilical/diagnóstico por imagem , Cordão Umbilical/patologia , Laparotomia/métodos
2.
Radiographics ; 41(7): 2090-2110, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34723700

RESUMO

The omphalomesenteric duct is an embryologic structure that connects the yolk sac with the primitive midgut of the developing fetus. Omphalomesenteric duct anomalies include a group of entities that result from failed resorption of the omphalomesenteric duct. These anomalies include Meckel diverticulum, omphalomesenteric fistula, fibrous bands, cysts, and umbilical polyps. Meckel diverticulum is the most common congenital anomaly of the gastrointestinal tract and is usually asymptomatic. Symptoms develop when Meckel diverticulum involves complications such as hemorrhage, inflammation, and perforation, or when it causes intussusception or bowel obstruction. Hemorrhage is the most common complication of Meckel diverticulum, and technetium 99m-pertechnetate scintigraphy is the imaging modality of choice for detecting acute bleeding. US and CT are commonly used for the evaluation of patients with other complications such as obstruction and inflammation. Nevertheless, the diagnosis of these complications can be challenging, as their clinical manifestations are usually nonspecific and can masquerade as other acute intraabdominal entities such as appendicitis, inflammatory bowel disease, or other causes of bowel obstruction. There are other umbilical disorders, such as urachal remnants and umbilical granuloma, that may present with symptoms and imaging findings similar to those of omphalomesenteric duct anomalies. An accurate preoperative diagnosis of omphalomesenteric duct anomaly is crucial for appropriate management and a better outcome, particularly when these anomalies manifest as a life-threatening condition. The authors review the anatomy, clinical features, and complications of omphalomesenteric duct anomalies in children, describing the relevant differential diagnoses and associated imaging findings seen with different imaging modalities. ©RSNA, 2021.


Assuntos
Obstrução Intestinal , Divertículo Ileal , Ducto Vitelino , Criança , Humanos , Divertículo Ileal/diagnóstico por imagem , Imagem Multimodal , Umbigo , Ducto Vitelino/diagnóstico por imagem
4.
Medicine (Baltimore) ; 95(42): e5196, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27759656

RESUMO

BACKGROUND: Umbilical cord hemangioma is very rare and may not be detected prenatally. However, it should be considered in differential diagnosis with other umbilical masses because it can cause significant morbidity. METHODS: We report the case of a newborn referred with suspected omphalitis and umbilical hernia. RESULTS: Physical examination showed an irreducible umbilical tumor, the size of olive, with dubious secretion. The initial suspected diagnosis was urachal or omphalomesenteric duct remnants. Abdominal ultrasound and magnetic resonance imaging showed an umbilical and a mesenteric mass. Tumor markers were negative. A definitive diagnosis of umbilical cord and intestinal hemangioma was established after surgical excision and histologic examination of the umbilical mass. Propranolol was prescribed due to the extent of the intestinal lesion. CONCLUSION: This report highlights the diagnostic challenges of hemangiomas in unusual locations. Apart from the rarity of these tumors, few tests are available to guide diagnosis, and surgery and histologic examination are generally required for a definitive diagnosis. Finally, it is essential to rule out associated malformations and hemangiomas in other locations.


Assuntos
Neoplasias Abdominais/diagnóstico , Hemangioma/diagnóstico , Imageamento por Ressonância Magnética/métodos , Ultrassonografia/métodos , Cordão Umbilical/diagnóstico por imagem , Ducto Vitelino/diagnóstico por imagem , Diagnóstico Diferencial , Feminino , Humanos , Recém-Nascido
5.
J Fam Pract ; 65(2): E1-3, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26977468

RESUMO

Consider a VID remnant as part of the differential diagnosis for any patient who has what appears to be a granulomatous umbilical lesion. Order ultrasonography to evaluate a suspected VID, especially for lesions that fail to respond to 2 or 3 silver nitrate treatments. Surgical excision of a VID remnant is usually curative.


Assuntos
Anormalidades do Sistema Digestório , Dissecação/métodos , Granuloma/diagnóstico , Ducto Vitelino , Criança , Diagnóstico Diferencial , Anormalidades do Sistema Digestório/diagnóstico , Anormalidades do Sistema Digestório/cirurgia , Humanos , Lactente , Masculino , Resultado do Tratamento , Ultrassonografia , Ducto Vitelino/anormalidades , Ducto Vitelino/diagnóstico por imagem , Ducto Vitelino/cirurgia
6.
BMJ Case Rep ; 20142014 Sep 16.
Artigo em Inglês | MEDLINE | ID: mdl-25228678

RESUMO

A 12-year-old boy with a history, at birth, of a weeping pink fleshy lesion after his umbilical cord detached, requiring repeated chemical cauterisation, presented with massive lower gastrointestinal bleeding and required resuscitation and blood transfusion. Augmented Tc99m nuclear medicine scan confirmed ectopic gastric mucosa. The lateral view suggested its attachment behind the umbilicus. At exploration, a latent vitellointestinal duct sinus with ectopic gastric mucosal mass was found. Segmental resection of the sinus and mass excision with primary anastomosis and incidental appendicectomy was curative. Pink fleshy mass discharging coloured fluid at the umbilicus following detachment of umbilical cord should be considered a remnant of vitellointestinal duct unless proved otherwise. A pink lesion with yellowish discharge resistant to chemical cauterisation should raise the suspicion of embryonic structures. Latent vitellointestinal sinus is a new lesion in the spectrum of umbilical anomalies. Lateral view of the nuclear medicine scan is helpful in locating the site.


Assuntos
Hemorragia Gastrointestinal/etiologia , Doenças do Íleo/diagnóstico por imagem , Fístula Intestinal/diagnóstico por imagem , Ducto Vitelino/anormalidades , Ducto Vitelino/diagnóstico por imagem , Criança , Coristoma/diagnóstico por imagem , Coristoma/cirurgia , Mucosa Gástrica/diagnóstico por imagem , Mucosa Gástrica/cirurgia , Humanos , Doenças do Íleo/complicações , Doenças do Íleo/cirurgia , Fístula Intestinal/complicações , Fístula Intestinal/cirurgia , Masculino , Cintilografia , Umbigo/diagnóstico por imagem , Ducto Vitelino/cirurgia
7.
J Coll Physicians Surg Pak ; 22(8): 524-6, 2012 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-22868020

RESUMO

The omphalomesenteric duct is an embryonic structure which connects the yolk sac to the midgut. The omphalomesenteric duct attenuates between the 5th and 9th week of gestation. Failure of the omphalomesenteric duct involution, either partial or complete, results in various omphalomesenteric duct remnants including Meckel's diverticulum, patent vitelline duct, fibrous band, sinus tract, umbilical polyp and cyst. Omphalomesenteric duct remnants are present in 2% of the population but related diseases have seldom been reported in adults. The simultaneous presence of sinus tract, omphalomesenteric cyst, fibrous ligament and Meckel's diverticulum has, according to authors' knowledge, never been reported. We present a case of a 23 years old male with persisting umbilical discharge for 2 years in whom there was coexistence of the above mentioned anomalies of the omphalomesenteric duct.


Assuntos
Intestino Delgado/anormalidades , Umbigo/anormalidades , Ducto Vitelino/anormalidades , Anormalidades Múltiplas/diagnóstico por imagem , Anormalidades Múltiplas/cirurgia , Adulto , Humanos , Intestino Delgado/cirurgia , Masculino , Divertículo Ileal/diagnóstico por imagem , Divertículo Ileal/cirurgia , Radiografia , Resultado do Tratamento , Umbigo/fisiopatologia , Umbigo/cirurgia , Ducto Vitelino/diagnóstico por imagem , Ducto Vitelino/cirurgia
8.
J Clin Ultrasound ; 39(7): 422-4, 2011 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-21484814

RESUMO

A female neonate with patent omphalomesenteric duct was treated by ductal excision. Six days following surgery, she developed vomiting and abdominal distension. On plain radiographs, distended bowel loops with multiple, air-fluid levels consistent with an intestinal obstruction were evident. Sonography demonstrated an ileo-ileal intussusception. At surgery, a 3-cm, ileo-ileal intussusception was noted proximal to the previous Lembert suture site and was manually reduced. Awareness of the possibility of small-bowel intussusception following surgery was critical to ensuring prompt and successful treatment of this infant.


Assuntos
Doenças do Íleo/diagnóstico , Intussuscepção/diagnóstico , Ducto Vitelino/cirurgia , Anormalidades do Sistema Digestório/diagnóstico , Anormalidades do Sistema Digestório/cirurgia , Feminino , Seguimentos , Humanos , Doenças do Íleo/etiologia , Doenças do Íleo/cirurgia , Recém-Nascido , Intussuscepção/etiologia , Intussuscepção/cirurgia , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/cirurgia , Reoperação/métodos , Medição de Risco , Índice de Gravidade de Doença , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento , Ultrassonografia Doppler/métodos , Ducto Vitelino/diagnóstico por imagem
9.
Fetal Diagn Ther ; 25(2): 250-4, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-19506385

RESUMO

We present a unique case of umbilical cord cysts of allantoic and omphalomesenteric remnants with progressive cord edema during pregnancy. Enlargement of the umbilical cord was observed initially at 28 weeks' gestation; the cord cysts were first recognized at 17 weeks. At 37 weeks, a cesarean section was performed and a male infant weighing 2,300 g was delivered. The entire length of the umbilical cord was 80 cm; the 50-cm proximal portion was strikingly edematous and was 7 cm in diameter. On the 1st day of life, operative exploration was undertaken via an infraumbilical incision. It was evident that a patent urachus protruded from the bladder. The lesion was excised and the bladder was closed in a two-layer anastomosis. Histologically, the intestinal epithelium was connected to the transitional epithelium at the top of the urachus, indicating allantoic remnants fused with omphalomesenteric remnants. Such a case has not been reported previously. It was considered that the overflow of urine from allantoic remnants to omphalomesenteric remnants caused the extraordinary edema of the umbilical matrix. Based on our experience, finding progressive umbilical cord edema may indicate a patent urachus co-existing with allantoic and omphalomesenteric remnants.


Assuntos
Alantoide/diagnóstico por imagem , Cistos/diagnóstico por imagem , Hidropisia Fetal/diagnóstico por imagem , Cordão Umbilical/diagnóstico por imagem , Úraco/anormalidades , Ducto Vitelino/diagnóstico por imagem , Adulto , Cistos/complicações , Feminino , Humanos , Hidropisia Fetal/etiologia , Recém-Nascido , Masculino , Gravidez , Ultrassonografia
10.
Turk J Gastroenterol ; 20(4): 282-6, 2009 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-20084574

RESUMO

Meckel's diverticulum is a remnant of the vitelline duct and a congenital anomaly of the gastrointestinal tract. Hemorrhage from a Meckel's diverticulum is common in children but extremely rare in adults over 50 years of age. Very few cases have been reported to date and all prior cases were in men. Meckel's diverticulum is commonly overlooked as a possible cause of a lower gastrointestinal hemorrhage in adults. Here, we present the rare case of a 58-year-old woman with massive hemorrhage from a Meckel's diverticulum that was diagnosed by repeated emergency angiographies and treated with elective laparoscopic surgery.


Assuntos
Angiografia , Hemorragia Gastrointestinal/diagnóstico por imagem , Divertículo Ileal/diagnóstico por imagem , Ducto Vitelino/diagnóstico por imagem , Feminino , Hemorragia Gastrointestinal/etiologia , Hemorragia Gastrointestinal/cirurgia , Humanos , Laparoscopia , Divertículo Ileal/complicações , Divertículo Ileal/cirurgia , Pessoa de Meia-Idade , Ducto Vitelino/anormalidades , Ducto Vitelino/cirurgia
11.
Ultrasound Obstet Gynecol ; 29(6): 708-11, 2007 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-17523163

RESUMO

We report a case of aneurysmal dilatation of a vitelline vein observed antenatally. Intra-abdominal vascular dilatation was diagnosed on ultrasound examination at 24 weeks' gestation. The relationship with the umbilicus and portal vein suggested the diagnosis of umbilical vein varix. Fetal tolerance remained excellent in spite of a gradual increase in the size of the dilated vein. Postnatal ultrasound examination revealed thrombosis of the aneurysm with gradual extension to the portal vein and the onset of serious coagulation problems. Operative findings on postnatal day 9 included the absence of intra-abdominal umbilical vein, and the presence of an abnormal, dilated and thrombosed vein connecting the umbilicus to the portal vein and following the trajectory of the right vitelline vein. Corrective surgery was attempted by resection of the aneurysm and portal thrombectomy, but this did not prevent the development of portal obstruction syndrome with cavernous hemangioma. This anomaly, in which the fetal venous return uses the vitelline vein in the absence of the umbilical vein, does not appear to have been described before. The mechanism in question could be anastomosis between the right vitelline vein and umbilical vein. Antenatal diagnosis should enable early surgical management before the formation of a portal thrombosis.


Assuntos
Aneurisma/diagnóstico por imagem , Ducto Vitelino/irrigação sanguínea , Adulto , Aneurisma/cirurgia , Feminino , Humanos , Recém-Nascido , Masculino , Gravidez , Resultado do Tratamento , Ultrassonografia Doppler em Cores , Ultrassonografia Pré-Natal/métodos , Veias/anormalidades , Veias/diagnóstico por imagem , Ducto Vitelino/diagnóstico por imagem
12.
Acta Radiol ; 47(1): 100-2, 2006 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-16498940

RESUMO

The vitelline or omphalomesenteric duct malformations constitute a rare group and are seen in only 2% of people. The malformations can take the form of a patent duct, a cyst, a fistula, or a sinus. They may or may not be symptomatic depending on the type of malformation. We present ultrasonographic features of a patent omphalomesenteric duct remnant in a 3-week-old boy who presented to our hospital with a non-healing umbilical lesion. Ultrasound can prove beneficial in the work-up of such cases.


Assuntos
Hérnia Umbilical/diagnóstico , Umbigo/anormalidades , Ducto Vitelino/anormalidades , Ducto Vitelino/diagnóstico por imagem , Hérnia Umbilical/cirurgia , Humanos , Recém-Nascido , Masculino , Doenças Raras , Ultrassonografia , Umbigo/diagnóstico por imagem , Umbigo/cirurgia , Ducto Vitelino/cirurgia
13.
Gynecol Obstet Invest ; 51(1): 66-8, 2001.
Artigo em Inglês | MEDLINE | ID: mdl-11150880

RESUMO

We present an unusual case in whom a small congenital hernia of the umbilical cord and associated patent omphalomesenteric duct were diagnosed at midtrimester ultrasonography. The diagnosis was confirmed following delivery, and neonatal corrective surgery was performed. We compare prenatal ultrasound findings of umbilical hernia and associated persistent omphalomesenteric duct with those of omphalocele.


Assuntos
Doenças Fetais/diagnóstico por imagem , Hérnia Umbilical/diagnóstico por imagem , Ultrassonografia Pré-Natal , Ducto Vitelino/diagnóstico por imagem , Adulto , Feminino , Hérnia Umbilical/cirurgia , Humanos , Recém-Nascido , Gravidez , Ducto Vitelino/cirurgia
14.
J Pediatr ; 136(4): 548-9, 2000 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-10753258

RESUMO

We describe the appearance of an iodinated, low molecular weight radiographic contrast agent, iohexol, in the intestines of twin neonates after administration to a pregnant mother during angiography. Nonionic contrast agents cross the human placenta and enter the fetus in significant concentrations and in this case facilitated identification of an omphalomesenteric duct cyst in one twin.


Assuntos
Meios de Contraste , Iohexol , Troca Materno-Fetal , Doenças em Gêmeos/diagnóstico , Feminino , Humanos , Recém-Nascido , Intestinos/diagnóstico por imagem , Masculino , Gravidez , Gravidez Múltipla , Radiografia , Ducto Vitelino/anormalidades , Ducto Vitelino/diagnóstico por imagem
15.
Radiographics ; 18(2): 413-31, 1998.
Artigo em Inglês | MEDLINE | ID: mdl-9536487

RESUMO

Umbilical disorders can be classified according to embryonic remnants contained in the umbilicus, including the urachus, omphalomesenteric duct, and round ligament of the liver; the extraperitoneal paravesical spaces; the umbilical ring; and the umbilicus itself. Only one of the five types of congenital urachal abnormalities (urachal cyst) is common. All anomalies associated with the omphalomesenteric duct are rare except the Meckel diverticulum, which is the most common congenital abnormality of the gastrointestinal tract. The round ligament contains the remnant of the umbilical vein, which in the presence of portal hypertension, may open, recanalize, and form a portosystemic collateral vessel. Extraperitoneal paravesical spaces that run from the umbilicus to the bladder may contain fluid collections. The umbilical ring and the umbilicus may give rise to many masses, including omphalocele, gastroschisis, various hernias, inflammatory and suppurative processes, and neoplasms. Clinical manifestations of umbilical disorders are usually nonspecific; use of cross-sectional imaging can help identify most of these entities because of their typical locations and distributions in continuity with the urinary bladder and the umbilicus and guide therapy. Understanding the anatomy and the differential diagnosis of umbilical disorders is key to arriving at a correct diagnosis and proper patient treatment.


Assuntos
Umbigo/diagnóstico por imagem , Abscesso/diagnóstico por imagem , Adulto , Idoso , Divertículo/diagnóstico por imagem , Feminino , Hérnia Umbilical/diagnóstico por imagem , Humanos , Masculino , Divertículo Ileal/diagnóstico por imagem , Pessoa de Meia-Idade , Neoplasias/diagnóstico por imagem , Radiografia , Ultrassonografia , Cisto do Úraco/diagnóstico por imagem , Úraco/anormalidades , Úraco/diagnóstico por imagem , Ducto Vitelino/anormalidades , Ducto Vitelino/diagnóstico por imagem
16.
Pediatr Radiol ; 26(5): 362-4, 1996.
Artigo em Inglês | MEDLINE | ID: mdl-8657469

RESUMO

Ultrasound of a patent urachus has been well described. However, ultrasound of the other congenital abnormalities affecting the umbilicus has not. Two cases are described, one of a vitelline (omphalomesenteric) duct and one of an umbilical granuloma, in which the ultrasound findings guided the child's management, preventing a minilaparotomy.


Assuntos
Granuloma/diagnóstico por imagem , Umbigo/anormalidades , Umbigo/diagnóstico por imagem , Humanos , Lactente , Masculino , Ultrassonografia , Ducto Vitelino/diagnóstico por imagem
17.
Pediatrie ; 47(1): 67-71, 1992.
Artigo em Francês | MEDLINE | ID: mdl-1337781

RESUMO

A brief report of 12 cases of congenital anatomical fistula (CUF) has been presented (4 cases of persistent omphalo-mesenteric, 3 persistent urachus, 4 urachal sinus, 1 persistent omphalo-mesenteric duct with urachus) with some general comments. CUF are discovered at birth or later in case of umbilical granuloma, redness, local swelling or umbilical discharge. Diagnosis and anatomical type are determined by instrumental exploration and fistulogram. Lower urinary obstruction should be eliminated in the case of persistent urachus. Complete excision is the correct treatment.


Assuntos
Fístula/congênito , Umbigo/anormalidades , Cateterismo , Pré-Escolar , Feminino , Fístula/diagnóstico por imagem , Fístula/cirurgia , Humanos , Lactente , Recém-Nascido , Masculino , Divertículo Ileal , Radiografia , Umbigo/cirurgia , Cisto do Úraco/diagnóstico por imagem , Cisto do Úraco/cirurgia , Úraco/diagnóstico por imagem , Úraco/cirurgia , Ducto Vitelino/diagnóstico por imagem
18.
Radiographics ; 11(1): 59-66, 1991 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-1996398

RESUMO

To facilitate an understanding of abnormalities related to the umbilical remnants, the authors present a simplified classification scheme on the basis of embryologic anatomic relationships. In a type 1 remnant, the entire duct (vitelline or urachus) is patent; in type 2, only one end is patent; and in type 3, only the midportion is patent. The authors illustrate and describe various entities in terms of this classification, including patent vitelline duct, umbilical sinus, Meckel diverticulum, vitelline cyst, patent urachus, urachal sinus, urachal diverticulum, and urachal cyst. With this scheme, imaging characteristics of the types of remnant abnormalities can be predicted. The result is a cogent approach to the radiologic evaluation of the patient with a suspected umbilical remnant anomaly.


Assuntos
Umbigo/anormalidades , Humanos , Divertículo Ileal/diagnóstico por imagem , Radiografia , Cordão Umbilical/embriologia , Umbigo/diagnóstico por imagem , Cisto do Úraco/diagnóstico por imagem , Ducto Vitelino/diagnóstico por imagem
19.
Pediatr Radiol ; 6(3): 147-52, 1977 Oct 28.
Artigo em Inglês | MEDLINE | ID: mdl-927977

RESUMO

Thirty pneumoperitoneograms were performed postmortem and 5 were performed for diagnosis: the technique itself, the radiological anatomy of the umbilical region, and the usefulness of the procedure in diagnosis are discussed. Pneumoperitoneum may be indicated in the investigation of a bleeding Meckel's diverticulum, in the exclusion or confirmation of remnants of the omphalomesenteric duct, in chronically moist lesions of the umbilicus resistant to symptomatic treatment, in suspected cases of non-communicating urachal cysts which cannot be diagnosed by cystogram, and in the differential diagnosis of abdominal tumours related to the umbilical region.


Assuntos
Neoplasias Abdominais/diagnóstico por imagem , Divertículo Ileal/diagnóstico por imagem , Pneumoperitônio Artificial , Pré-Escolar , Humanos , Lactente , Recém-Nascido , Masculino , Radiografia , Bexiga Urinária/anormalidades , Ducto Vitelino/diagnóstico por imagem
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