Kysucan J, Malý T, Neoral C
I. Chirurgická klinika FN Olomouc.
Rozhl Chir. 2010 Dec;89(12):764-9.
Umbilicus is a scar, which is the place of the previous merger of the fetus with the umbilical cord. After birth, it has no known function, however, unless the umbilical annulus is completely closed, umbilical hernia may occur. Umbilical scar is also an area where may occur a number of anomalies that may be present alone or together with umbilical hernia. Failure of involution leads to persistence of omphalomesenteric duct and urachal remnants. These embryonic remnants may cause more or less significant clinical problems, or may be completely asymptomatic and may be diagnosed at random.
The authors present their own group of patients who were diagnosed and dealt with the defect omphalomesenteric duct or urachus. In past 7 years we observed 35 children with these abnormalities. A large group of patients represents incidental findings during elective surgery for umbilical hernia. Another large group are patients with symptomatic or asymptomatic Meckel's diverticulum. The anatomical observations, clinical manifestations, complications and treatment of these anomalies are mentioned.
A total of 35 children were found with these birth defects. In 23 cases we observed omphalomesenteric duct disorders and 12 urachal remnants were reported. Of these, 12 abnormalities were found incidentally during elative procedure for umbilical hernia. Asymptomatic or symptomatic Meckel's diverticulum appeared in 16 cases. Surgical treatment included resection or exstirpation, if urachal anomaly was accompanied then partial resection of the bladder vertex was added. Postoperative complications emerged in 4 cases, three times it was ileus from adhesions 6 months after surgery, once postoperative cystitis appeared and was treated conservatively.
Birth abnormalities of the umbilicus are relatively rare diseases that may occur in the pediatric population. Omfalomesenteric duct and urachal anomalies constitute a major group of these congenital disorders and are often associated with umbilical hernia. They can be diagnosed soon after birth or later in life. Surgical treatment involves excision or radical exstirpation to prevent early or late complications (urachal carcinoma in adulthood).
脐是一道瘢痕，是胎儿先前与脐带相连之处。出生后，它并无已知功能，然而，除非脐环完全闭合，否则可能会发生脐疝。脐瘢痕也是一个可能出现多种异常的区域，这些异常可能单独出现，也可能与脐疝同时存在。退化不全可导致卵黄管和脐尿管遗迹持续存在。这些胚胎遗迹可能会引发或多或少的显著临床问题，也可能完全无症状，只是在偶然情况下被诊断出来。
作者介绍了他们自己诊断和处理卵黄管或脐尿管缺陷的患者群体。在过去7年里，我们观察了35例患有这些异常的儿童。一大组患者是在脐疝择期手术中偶然发现的。另一大组是有症状或无症状的梅克尔憩室患者。文中提到了这些异常的解剖学观察、临床表现、并发症及治疗方法。
共发现35例患有这些先天性缺陷的儿童。我们观察到23例卵黄管疾病，报告了12例脐尿管遗迹。其中，12例异常是在脐疝相关手术过程中偶然发现的。16例出现了无症状或有症状的梅克尔憩室。手术治疗包括切除或摘除，如果伴有脐尿管异常，则加做膀胱顶部部分切除。术后出现4例并发症，3次是术后6个月因粘连导致肠梗阻，1次出现术后膀胱炎，经保守治疗。
脐部先天性异常是儿科人群中相对罕见的疾病。卵黄管和脐尿管异常是这些先天性疾病的主要类型，且常与脐疝相关。它们可在出生后不久或日后被诊断出来。手术治疗包括切除或根治性摘除，以预防早期或晚期并发症（成年期脐尿管癌）。
