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Ultrasonographic diagnosis and minimally invasive treatment of a patent urachus associated with a patent omphalomesenteric duct in a newborn: A case report

RATIONAL: Patent urachus (PU) is due to an incomplete obliteration of the urachus, whereas patent omphalomesenteric duct (POMD) is due to an incomplete obliteration of the vitelline duct. These anomalies are very rarely associated with one another. We describe a case of a newborn with a PU associate...

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Autores principales: Bertozzi, Mirko, Recchia, Nicola, Di Cara, Giuseppe, Riccioni, Sara, Rinaldi, Victoria Elisa, Esposito, Susanna, Appignani, Antonino
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5627799/
https://www.ncbi.nlm.nih.gov/pubmed/28746173
http://dx.doi.org/10.1097/MD.0000000000007087
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author Bertozzi, Mirko
Recchia, Nicola
Di Cara, Giuseppe
Riccioni, Sara
Rinaldi, Victoria Elisa
Esposito, Susanna
Appignani, Antonino
author_facet Bertozzi, Mirko
Recchia, Nicola
Di Cara, Giuseppe
Riccioni, Sara
Rinaldi, Victoria Elisa
Esposito, Susanna
Appignani, Antonino
author_sort Bertozzi, Mirko
collection PubMed
description RATIONAL: Patent urachus (PU) is due to an incomplete obliteration of the urachus, whereas patent omphalomesenteric duct (POMD) is due to an incomplete obliteration of the vitelline duct. These anomalies are very rarely associated with one another. We describe a case of a newborn with a PU associated with a POMD, who was diagnosed by an abdominal ultrasound (US) and laparoscopy, and managed with a minimally invasive excision. PATIENT CONCERN: A 28-day-old male neonate was referred to our hospital to investigate a delay in umbilical healing, with blood-mucinous material spillage for 3 weeks prior to the referral. The baby had no symptoms and was in good general health. DIAGNOSIS: After a thorough cleaning of the umbilical stump, a clear granuloma with a suspected fistula was evident under the seat of the ligature of the stump. An abdominal US examination revealed the formation of a full communication, starting below the umbilical stump and developing along the anterior abdominal wall that connected with the bladder dome. The US also revealed a tubular formation containing air, which was compatible with POMD, in the deepest portion of the same umbilical stump. Considering these findings, the rare diagnosis of a PU associated with a POMD duct was suspected. INTERVENTIONS: The child was then hospitalized for an elective laparoscopy that confirmed the US picture, and a minimally invasive excision was performed. OUTCOME: The postoperative course was favorable and uneventful. LESSONS: Our case underlines the importance of evaluating all persisting umbilical lesions without delay when conventional pharmacological therapies fail. Using a US as the first approach is valuable and should be supported by laparoscopy to confirm the diagnosis; a minimally invasive excision of the remnants appears to be an effective therapeutic approach.
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spelling pubmed-56277992017-10-12 Ultrasonographic diagnosis and minimally invasive treatment of a patent urachus associated with a patent omphalomesenteric duct in a newborn: A case report Bertozzi, Mirko Recchia, Nicola Di Cara, Giuseppe Riccioni, Sara Rinaldi, Victoria Elisa Esposito, Susanna Appignani, Antonino Medicine (Baltimore) 6200 RATIONAL: Patent urachus (PU) is due to an incomplete obliteration of the urachus, whereas patent omphalomesenteric duct (POMD) is due to an incomplete obliteration of the vitelline duct. These anomalies are very rarely associated with one another. We describe a case of a newborn with a PU associated with a POMD, who was diagnosed by an abdominal ultrasound (US) and laparoscopy, and managed with a minimally invasive excision. PATIENT CONCERN: A 28-day-old male neonate was referred to our hospital to investigate a delay in umbilical healing, with blood-mucinous material spillage for 3 weeks prior to the referral. The baby had no symptoms and was in good general health. DIAGNOSIS: After a thorough cleaning of the umbilical stump, a clear granuloma with a suspected fistula was evident under the seat of the ligature of the stump. An abdominal US examination revealed the formation of a full communication, starting below the umbilical stump and developing along the anterior abdominal wall that connected with the bladder dome. The US also revealed a tubular formation containing air, which was compatible with POMD, in the deepest portion of the same umbilical stump. Considering these findings, the rare diagnosis of a PU associated with a POMD duct was suspected. INTERVENTIONS: The child was then hospitalized for an elective laparoscopy that confirmed the US picture, and a minimally invasive excision was performed. OUTCOME: The postoperative course was favorable and uneventful. LESSONS: Our case underlines the importance of evaluating all persisting umbilical lesions without delay when conventional pharmacological therapies fail. Using a US as the first approach is valuable and should be supported by laparoscopy to confirm the diagnosis; a minimally invasive excision of the remnants appears to be an effective therapeutic approach. Wolters Kluwer Health 2017-07-28 /pmc/articles/PMC5627799/ /pubmed/28746173 http://dx.doi.org/10.1097/MD.0000000000007087 Text en Copyright © 2017 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nd/4.0 This is an open access article distributed under the Creative Commons Attribution-No Derivatives License 4.0, which allows for redistribution, commercial, and noncommercial, as long as it is passed along unchanged and in whole, with credit to the author. http://creativecommons.org/licenses/by-nd/4.0
spellingShingle 6200
Bertozzi, Mirko
Recchia, Nicola
Di Cara, Giuseppe
Riccioni, Sara
Rinaldi, Victoria Elisa
Esposito, Susanna
Appignani, Antonino
Ultrasonographic diagnosis and minimally invasive treatment of a patent urachus associated with a patent omphalomesenteric duct in a newborn: A case report
title Ultrasonographic diagnosis and minimally invasive treatment of a patent urachus associated with a patent omphalomesenteric duct in a newborn: A case report
title_full Ultrasonographic diagnosis and minimally invasive treatment of a patent urachus associated with a patent omphalomesenteric duct in a newborn: A case report
title_fullStr Ultrasonographic diagnosis and minimally invasive treatment of a patent urachus associated with a patent omphalomesenteric duct in a newborn: A case report
title_full_unstemmed Ultrasonographic diagnosis and minimally invasive treatment of a patent urachus associated with a patent omphalomesenteric duct in a newborn: A case report
title_short Ultrasonographic diagnosis and minimally invasive treatment of a patent urachus associated with a patent omphalomesenteric duct in a newborn: A case report
title_sort ultrasonographic diagnosis and minimally invasive treatment of a patent urachus associated with a patent omphalomesenteric duct in a newborn: a case report
topic 6200
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5627799/
https://www.ncbi.nlm.nih.gov/pubmed/28746173
http://dx.doi.org/10.1097/MD.0000000000007087
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