Assessment of the umbilical cord outside of the delivery room. Part 2

Combined omphalomesenteric and urachal remnants in an 18-month-old girl

A toddler with a persistent congenital umbilical papule is described. The papule was found to contain both omphalomesenteric and urachal remnants. This patient's findings illustrate the importance of further evaluation of umbilical lesions when conventional therapy with silver nitrate fails.

Look twice before you clamp: decapitation of an omphaloenteric duct. A case report

OBJECTIVE

To report a case of accidental decapitation of a persistent omphaloenteric duct (POD) in congenital hernia of the umbilical cord in a newborn male.

CASE PRESENTATION AND INTERVENTION

The newborn was transferred to an intensive care unit, where under closer inspection the diagnosis of an omphalocele was presumed. Surgical exploration at our Pediatric Surgical University Clinic revealed a clamped and decapitated POD in the umbilical cord. The decapitation had gone unnoticed due to severe asphyxia resulting from meconium aspiration encountered at the time of delivery. Using general anesthesia, the clamp was removed under sterile conditions. The decapitation of the POD in the herniated umbilical cord was confirmed at this time. The severed intestine was sutured and closed using 5-0 Vicryl sutures. The further course was uneventful.

CONCLUSION

Herniation of the umbilical cord at the time of birth by intestinal loops or POD is rare, but caution should be taken by midwives before clamping in order to avoid the type of injury seen in this case.