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CASE REPORT
Year : 2020  |  Volume : 33  |  Issue : 2  |  Page : 720-721

Patent vitellointestinal duct with foreign body: a rare case


Department of Pediatric Surgery, SMS Medical College, Jaipur, Rajasthan, India

Date of Submission02-Aug-2018
Date of Decision30-Sep-2018
Date of Acceptance09-Oct-2018
Date of Web Publication27-Jun-2020

Correspondence Address:
Aditya P Singh
MCh in Pediatric Surgery, Near The Mali Hostel, Main Bali Road, Falna, Pali, Rajasthan
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/mmj.mmj_225_18

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  Abstract 


Patent vitellointestinal duct (PVID) is one of the congenital malformation of incomplete obliteration of the vitelline duct. The foreign body impaction in PVID is a rare cause of gastrointestinal obstruction in the children. Here we are presenting a case of a 1-year-old child who presented with abdominal pain and bilious vomiting. Patient had history of serous umbilical discharge since birth. On exploration, we found a watermelon seed in the lumen of PVID. It was obstructing the lumen of small intestine. Foreign body was removed, and resection of patent duct was done. Moreover, an end-to-end ileoileal anastomosis was performed. Patient was discharged uneventfully.

Keywords: foreign body, impaction, obstruction, patent vitellointestinal duct, watermelon seed


How to cite this article:
Garg D, Singh AP, Mathur V, Barolia DK. Patent vitellointestinal duct with foreign body: a rare case. Menoufia Med J 2020;33:720-1

How to cite this URL:
Garg D, Singh AP, Mathur V, Barolia DK. Patent vitellointestinal duct with foreign body: a rare case. Menoufia Med J [serial online] 2020 [cited 2020 Jul 16];33:720-1. Available from: http://www.mmj.eg.net/text.asp?2020/33/2/720/287762




  Introduction Top


Patent vitellointestinal duct (PVID) is one of the congenital malformation of incomplete obliteration of the vitelline duct. Its incidence varies from 1 in 5000–8000 live births. It usually presents as feculent or serous discharge through the umbilicus. In ∼2% of humans, this duct persists and gives rise to a group of anomalies, of which, Meckel's diverticulum is the commonest, and complete patency of the duct is the rarest anomaly[1].


  Case Report Top


A female child of 1 year of age was brought to the pediatric surgical outdoor with complaints of abdominal pain and bilious vomiting for the past 3 days. She had a history of serous discharge from umbilicus since birth. The patient was hemodynamically stable. On physical examination, her abdomen was mildly distended and nontender. Serous discharge was present in the umbilicus. There was PVID with dilated bowel loops in ultrasound report. On abdominal radiography, there were few dilated bowel loops. Air fluid levels were present on radiography, suggestive of intestinal obstruction. Blood investigations were within normal limit, including complete blood counts, renal function test, and serum electrolytes. The patient was operated on the same day. Umbilicus was dissected by circumferential incision. During dissection, we found a watermelon seed present in the lumen of vitellointestinal duct [Figure 1] and [Figure 2]. It was present at the junction of duct with small intestine. It was obstructing the lumen of small intestine. Foreign body was removed, and resection of patent duct was done, and an end-to-end ileoileal anastomosis was performed. Patency of small intestine was checked and abdomen was closed. The patient was started on oral feeds on the sixth postoperative day. Postoperative period was unremarkable, and the patient was discharged after 8 days. On follow-up, the patient was well. Histopathology report showed PVID in the resected segment.
Figure 1: Photograph showing patent vitellointestinal duct.

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Figure 2: Photograph showing watermelon seed with PVID. PVID, patent vitellointestinal duct.

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  Discussion Top


Most of the ingested foreign bodies pass through the gastrointestinal tract spontaneously. Few stuck in the anatomical transition regions. Esophagus and small bowel are the most common locations involved[2],[3]. Sharp foreign bodies may lead to perforation and erosion into adjacent organs[4]. In the presented case, the patient had discharge since birth, but foreign body in lumen of patent duct led to intestinal obstruction and bilious vomiting.

Intestinal perforation in obstructed umbilical hernia owing to a foreign body is very rare[5]. We could not found any similar case of foreign body impaction in PVID causing intestinal obstruction in the literature, so probably this is the first case of such type.

Acknowledgments

Dr Maryem Ansari, pathologist, Assistant professor, SMS Medical College Jaipur.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Rao PL, Mitra SK, Pathak IC. Patent vitellointestinal duct. Indian J Pediatr 1979; 46 :215–218.  Back to cited text no. 1
    
2.
Gregori D, Scarinzi C, Morra B, Salerni L, Berchialla P, Snidero S, et al. Ingested foreign bodies causing complications and re-quiring hospitalization in European children: results from the ESFBI study. Pediatr Surg Int 2010; 52 :26–32.  Back to cited text no. 2
    
3.
Goh BK, Chow PK, Quah HM, Ong HS, Eu KW, Ooi LL, et al. Perforation of the gastrointestinal tract secondary to ingestion of foreign bodies. World J Surg 2006; 30 :372–377.  Back to cited text no. 3
    
4.
Stack LB, Munter DW. Foreign bodies in the gastrointestinal tract. Emerg Med Clin North Am 1996; 14 :493–521.  Back to cited text no. 4
    
5.
Gupta R, Mujalde VS, Gupta S, Gupta PK, Bhandari A, Mathur P. Intestinal perforation in obstructed umbilical hernia due to wedged plum seed. APSP J Case Rep 2016; 7 :25.  Back to cited text no. 5
    


    Figures

  [Figure 1], [Figure 2]



 

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