Surgical abdominal exploration in children with umbilical ectopic gastrointestinal tissue

Hou, Yi-Li; Lin, Jao-Yu

doi:10.1016/j.epsc.2019.101281

Cited by 3 publications

(11 citation statements)

References 16 publications

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“…Regardless, it appears prudent to obtain a similar workup as for umbilical polyps. In a review of 14 patients with umbilical heterotopic GI tissue who underwent surgical exploration, nine (64%) had a coexistent OMD remnant 3 . Similar rates of OMD remnant and umbilical polyp co‐occurrence were found in a separate review 8 …”

Section: Discussionmentioning

confidence: 63%

“…Heterotopia is the abnormal presence of well‐differentiated tissue in a non‐physiologic location with coexistent, retained native tissue. The cause of gastric heterotopia is not well understood; theories include abnormal differentiation of endodermal cells (possibly due to underlying mesodermal signaling) and abnormal migration of embryonic tissue 3,4 . Heterotopic gastric mucosa has been documented throughout the gastrointestinal (GI) tract and is a rare cause of an umbilical nodule, with fewer than 10 cases reported.…”

Section: Discussionmentioning

confidence: 99%

“…If the ultrasound is non‐diagnostic or identifies a concerning feature then CT or MRI should be obtained 1,9 . Some authors have questioned the sensitivity of imaging in identifying OMD remnants and recommend routine surgical exploration 3 . However, in one report of 13 patients with draining umbilical polyps, six underwent surgical exploration without OMD remnant identified; seven did not have surgery and remained asymptomatic after mean of 5.8 years 10 .…”

Section: Discussionmentioning

confidence: 99%

“…Neither the true rate of co‐occurrence of umbilical polyps with OMD or heterotopic gastric mucosa nor percentage of umbilical polyps that develop complications is known. When clinical or radiographic evaluation is concerning, a mini‐laparotomy or laparoscopy is typically performed 1,3–6,9 …”

Section: Discussionmentioning

confidence: 99%

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Umbilical nodule present since birth

Kang

Mitchell

Stepenaskie

et al. 2022

Pediatric Dermatology

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Section: Discussionmentioning

confidence: 63%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Umbilical nodule present since birth

Kang

Mitchell

Stepenaskie

et al. 2022

Pediatric Dermatology

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“…Failure to achieve regression leads to excision, and histopathology results showed intestinal mucosa rather than proliferating capillary network seen in the granuloma. Controversy exists regarding the need for abdominal exploration in case an ectopic umbilical gastrointestinal tissue is discovered to be co-existent with intra-abdominal component of OMD remnant [ 17 , 18 ], In our study, umbilical or abdominal exploration was not performed, and all patients remained asymptomatic on follow-up. We recommend abdominal exploration only if clinically indicated.…”

Section: Discussionmentioning

confidence: 97%

Spectrum of Omphalomesenteric Duct Related Anomalies and Their Surgical Management in Children

Azhar¹,

Zamir

Taqvi

et al. 2021

Cureus

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Objective The aim of this study was to evaluate the clinical presentation and surgical management of omphalomesenteric duct (OMD) remnants in children. Material and methods A descriptive retrospective study was conducted at the Department of Paediatric Surgery of the National Institute of Child Health, Karachi, Pakistan, from April 2017 to January 2020. Children below 12 years of age with various OMD remnants were included in the study. Data regarding age of presentation, type of anomaly, and management collected during this period were reviewed and analyzed using SPSS Version 22 (IBM Corp., Armonk, NY, USA). Results A total of 86 patients, 47 males and 39 females, were managed during the study period. Intestinal obstruction was observed in 44 (51.16%) cases followed by OMD-related umbilical anomalies in 14 (16.27%) cases, acute abdominal pain in 12 (13.95%), rectal bleeding in 3 (3.48%) patients. In 13 (15.16%) cases, Meckel’s diverticulum was discovered incidentally. In 21 cases, wedge resection and ileal repair was performed, whereas 32 required segmental resection and end-to-end anastomosis, and in 32 cases ileostomy was created after resection. Histopathology showed the presence of ectopic mucosa in five cases. Conclusion Patients with OMD remnants had various presentations. The surgical procedure has to be tailored according to the clinical and surgical findings.

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Standardization of the Umbilical Scarectomy and Exploratory Laparotomy for Umbilical Mucosal Polyps

Tomita,

Shimojima,

Matsuoka

et al. 2024

Cureus

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Background Umbilical mucosal polyps are common, but physicians’ unfamiliarity with them can prolong the patient’s illness. Furthermore, the details of surgery for umbilical mucosal polyp removal are not well documented. Methods Patients with an umbilical mucosal polyp diagnosed on the basis of the lesion’s characteristic appearance were prospectively enrolled. The surgery involved an umbilical scarectomy with the removal of a minimum of the surrounding skin and an exploratory laparotomy to detect any lesions extending into the peritoneal cavity. Results Fourteen patients with a median duration of illness of ten months (range: one month to seven years) were enrolled, and 13 (92.9%) received surgery while one patient whose symptoms resolved following topical steroid treatment did not. Inspection of the intestinal mucosa of all the patients found lesions deep within the umbilicus in four (30.8%) of the 13 surgical patients, including an omphalomesenteric band, umbilical cyst, and umbilical sinus with gastric mucosa in one, one, and two patients, respectively. The postoperative course was uneventful except for one patient who had temporary granulation. Conclusions Umbilical mucosal polyps can be readily diagnosed by their characteristic appearance, thereby preventing the prolongation of illness. An umbilical scarectomy and abdominal exploration may be useful for preventing recurrences and intestinal obstruction.

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Surgical abdominal exploration in children with umbilical ectopic gastrointestinal tissue

Cited by 3 publications

References 16 publications

Umbilical nodule present since birth

Umbilical nodule present since birth

Spectrum of Omphalomesenteric Duct Related Anomalies and Their Surgical Management in Children

Standardization of the Umbilical Scarectomy and Exploratory Laparotomy for Umbilical Mucosal Polyps

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