Persistent omphalomesenteric duct with umbilicus polipus and Meckel’s diverticulum

Abstract

The persistence of the omphalomesenteric duct (OMD) is an uncommon presentation within the embryological alterations of the vitelline remnant. Its clinical presentation varies according to the underlying anatomical malformation, which is difficult to diagnose as complementary imaging studies can be negative. Objective: To report the clinical case of an infant with a long standing moist navel, in whom a persistence of the OMD associated with Meckel’s diverticulum was evidenced intraoperatively; highlighting the importance of proper suspicion and management of this type of lesions. 

Clinical Case: A 1-month-old male infant with a round, reddish, and moist umbilical lesion, previously diagnosed as umbilical granuloma. He was referred to pediatric surgery for evaluation and management of the lesion, where an umbilical polyp was diagnosed, and a complementary study was performed looking for other embryological abnormalities. Abdominal and soft tissue ultrasound was negative for other abnormalities, reporting an umbilical granuloma. Due to the persistence of the lesion and its highly suggestive appearance of a polyp and moist navel, surgical resolution was decided. Surgery was performed at 7 months, and during the operation, a persistence of the OMD with Meckel’s diverticulum was found. Resection surgery of the remnant was performed, with good postoperative evolution.

Conclusions: The case presented highlights the importance of diagnostic suspicion and timely referral before complications arise. When faced with umbilical lesions that are characterized by prolonged evolution and associated with periumbilical moisture, embryological alterations that require a correct study and surgical management should be suspected.