Omphalomesenteric duct remnant rarely occurs but must be examined in infants

The presence of omphalomesenteric duct (OMD) is quite rare in infants, but clinicians are advised to consider this remnant while examining patients with umbilical abnormalities, according to a recent study, noting that mismanagement may lead to severe morbidity and mortality.

“Meticulous inspection of the umbilicus at birth might reveal a persisting embryonic remnant, such as an OMD, manifested by a variety of cutaneous signs, such as an umbilical mass, granulation tissue or discharge,” the investigators said.

This study sought to evaluate the available data regarding the presence and management of OMD remnant with cutaneous involvement to propose a practical approach for diagnosis and treatment. The investigators performed a systematic review of the literature evaluating OMD anomalies presenting with cutaneous symptoms. Apart from this, they also presented an index case of an 11-month-old patient.

Fifty-nine publications, which included a total of 536 patients, met the inclusion criteria. Of the patients whose age was noted, 97 percent were infants (mean age, 11 months).

Diagnosis was established in 7.5 percent of patients only after treatment failure. Nonlethal complications were reported in 6.4 percent of patients. In addition, nearly one in 10 infants (10.3 percent) succumbed to death, partly due to either delayed diagnosis or mismanagement.

This study had certain limitations, which included limited quality of the collected data and potential bias, according to the investigators.

“Disorders of the umbilicus are commonly seen in infancy, including hernias, infections, anomalies, granulomas and malignancies,” they noted.