The omphalomesenteric duct (OMD, vitelline duct) connects the yolk sac and small bowel. It usually regresses by the ninth week of gestation leaving a fibrous cord. Persistence of all or part of the omphalomesenteric duct may present with a variety of clinical findings.
Clinical Finding
Significance
umbilical discharge (feculent, bilious or serosanguinous)
entire duct patent
discolored skin lesion at the umbilicus
ectopic gastric or intestinal tissue
cystic mass in the lower anterior abdominal wall in the midline
persistent midportion of the duct with both ends closed
abscess at the umbilicus or in underlying tissues
infected cyst or involvement of duct remnant that opens to the skin surface
small bowel obstruction
due to volvulus, fibrous band or other mechanism
prolapse of ileum at the umbilicus
entire duct patent
Meckel’s diverticulum
persistent duct at intestinal end with fibrosis in mid and distal portions of the duct
umbilical hernia
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