Background Congenital hernia of umbilical cord is a rare congenital anomaly. Due to its presentation as herniation of small bowel or other viscera into the umbilical cord, it is often misdiagnosed as omphalocele minor. Case presentation We are reporting a rare case of congenital hernia of umbilical cord which presented with rupture of hernia sac and evisceration of small bowel loops with reverse ileal intussusception via a patent vitellointestinal duct. It was managed by first repositioning the gut with stoma at umbilical site as a temporizing measure followed by definitive surgery in the form of resection of patent vitellointestinal duct and end to end ileal anastomosis. Conclusion Congenital hernia of umbilical cord with patent vitellointestinal duct is a rare abdominal wall defect which can present beyond neonatal period with evisceration of gut. A high index of suspicion should be kept by the first attending clinician to avoid a delay in management.
Coronavirus infectious disease-19 (COVID-19) has caused serious threat to global health. With progression of time, more and more cases are being reported in paediatric age group. Management of COVID-19-positive neonates with surgical condition is challenging as apart from medical management of COVID-19-induced morbidities, they also require surgical intervention. Various guidelines have been proposed for the management of neonates with coronavirus infection and surgical pathologies. In this original article, we are sharing our experience in managing such neonates. We managed five neonates with different surgical pathologies who were positive for the coronavirus at the time of admission. They received medical management initially. Three of these five neonates were operated after they were negative for the virus. The remaining two patients were operated in positive state due to their condition requiring urgent surgical intervention. All the recommendations as per the COVID-19 protocol were followed. Four of these babies survived. One neonate with the diagnosis of gastroschisis expired during stay in designated COVID-19 neonatal intensive care unit. Authors conclude that COVID-19-positive status of neonates should not scare the health-care workers. COVID-19 positivity in neonates does not alter the outcome.
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