Patent OMD (umbilical enteric fistula)

 

Patent OMD (umbilical enteric fistula)

Patent conduit connecting the umbilicus to the ileum, is one of the least common variants of OMD anomalies and usually presents with minimal but persistent discharge of intestinal contents or stool at the umbilicus.

Diagnosis is usually made during infancy as feces or bilious drainage is noted at the umbilicus.

Severe, erosive dermatitis may occur in the skin adjacent to the umbilicus due to the irritating effects of fecal drainage.

It should be treated early with laparotomy or laparoscopy and excision of the duct to avoid intussusception or volvulus.

UMBILICAL POLYP

 

UMBILICAL POLYP

An umbilical polyp is a remnant of OMD or urachal embryologic remnant.

An umbilical polyp may coexist with OMD or urachal sinus, cyst, fistula, or a band and may be associated with urine or fecal discharge.

Umbilical polyps present as a bright red, firm, painless mass with mucoid/bloody discharge.

They may be mistaken clinically for umbilical granulomas or pyogenic granulomas, which may have a pink or velvety appearance.

Unlike umbilical granulomas,umbilical polyps do not respond to chemical cauterization.

Histopathologic evaluation is warranted if there is any doubt whether an umbilical mass in a neonate is a polyp or granuloma. If a polyp is diagnosed, further evaluation for associated embryologic anomalies (eg, MD) should be performed.Umbilical polyps are associated with an underlying OMD anomaly in 30% to 60% of patients.

In such conditions, ultrasonography or fistulography may be beneficial.

Early diagnosis and treatment of an umbilical polyp may decrease the risk of associated complications.

Treatment is surgical excision of the entire omphalomesenteric or urachal remnant.