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KMID : 0371319740160110051
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Journal of the Korean Surgical Society
1974 Volume.16 No. 11 p.51 ~ p.58
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Omphalo mesenteric duct anomalies -Report of 24 cases
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鄭啓孝/Chung, Ge Ho
黃毅浩/Hwang, Eui Ho
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Abstract
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During the 3rd week of emryonic life there is a communication between the gut and the yolk sac. As development proceeds, the communication narrows-into a tube, the vitello-intestinal duct. As placental nutrition becomes established, this duct is usually obliterated by the end of the 7th week.
Incomplete obliteration of the embryonic omphalomesenteric duct leads to the formation of a number of congenital abnormalities capable of producing a wide variety of clinical disturbances.
The formation of a Meckel´s diverticulum is by far the commonest result of these; ocurred in from 2~4% of populasion from autopsy. The pathologic diverticulum, however, are encountered in only a small number of the person in whom it occur. Furthermore, completely patent omphalomesenteric duct is extremely rare; an incidence of-0.0063% has been reported for live birth.
´We -experienced 24 cases of anomalies of omphalomesenteric duct of, 14 years duration from 1960 to 1973 at Surg. Dept., Yonsei University College bf Medicine, Seoul, Korea.
Results as follow;
1. Ratio of pathologic group and incidental one was 11 : 13. 2. 18 of the 24 patients were male and 6 were female.
3. The average age in pathologic group was 13 years, but one of the incidental group was 23 years.
4. The principal symptoms were abdominal pain(73%), intestinal obstruction(64%) and melena {18%x.
5. Over half of the the patients of pathologic group gave rise of symptoms in their 5 years of life.
6. Types of these encountered Meckel´s diverticulum; 19 (Incidental; 13 and Pathologic; 6),diverticulum attached to umbilicus by fibrous band; 2; congenital band; 1, and patent omphalomesenteric duct; 2 (One of these was completely patent and the other was incompletely patent).
7. Types of lining mucosa in 24 cases studied microscopically were ileal; 18, ileal and gastric; 3, ileal, gastric and pancreas; 1, and ileal and pancreas; 1.
8. Diagnosis of the pathologic group was made on emergent exploratory laparatomy.
9. Treatment was easily done under the excision of the Meckel´s diverticulum with primary closure and the corrrection of the corresponding bowel obstruction.
10. No postoperative morbidity and mortality were noted except one of the incidental group;
prematurity with congenital esophageal atresia and tracheo-esophageal fistula, suddenly died on
2nd hospital day.
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