Omphalomesenteric duct remnants

Abstract

The omphalomesenteric duct is an embryonic communication between the primitive yolk sac and the developing midgut, and failure of resorption leads to a spectrum of anomalies. Meckel's diverticulum is the most common anomaly that results from the failure of resorption of the omphalomesenteric duct. Other less common anomalies seen in children include persistent fibrous cord, umbilical fistula, omphalomesenteric cyst and umbilical polyps. These remnants can have variable clinical manifestations, such as umbilical discharge, small bowel obstruction, gastrointestinal tract bleeding or acute abdomen. Investigation is tailored according to symptom(s) in the paediatric population, and operative resection represents a cornerstone of most treatment(s). Published reports also show neoplasms may develop in omphalomesenteric duct remnants, indicating controversy for resection in asymptomatic patients.