Sy Edgar D, Shan Yen-Shen, Lin Chyi-Her
National Cheng Kung University Hospital, Tainan, Taiwan; National Cheng Kung University Medical College, Tainan, Taiwan.
National Cheng Kung University Hospital, Tainan, Taiwan; National Cheng Kung University Medical College, Tainan, Taiwan.
Int J Surg Case Rep. 2018;47:45-47. doi: 10.1016/j.ijscr.2018.04.012. Epub 2018 Apr 16.
Combination vitelline fistula (VF) and omphalocele at birth is a rare congenital anomaly as a result disturbance in organogenesis with failure of normal return of intestines into the abdominal cavity and failed obliteration of the vitelline duct.
A newborn presented with omphalocele sac with visible intestine, stoma like lesion with prolapsing mucosa just lateral to the umbilical cord and passage of meconium stool. Operative surgery was confirmed an intact omphalocele sac and vitelline fistula. Fistulectomy, using wedge resection of the small bowel and primary closure abdominal wall defect.
In our review of literature, VF associated with omphalocele had not been reported. Combination of anomaly maybe misleading, however, can be easily diagnosed the location of VF opening on the omphalocele sac, which is adjacent to the umbilical cord and luminal passage of meconium stool after birth. A fistulogram may be the best initial diagnostic imaging approach for identifying and confirmation of a fistula tract.
VF associated with omphalocele is rare. Post-natal diagnosis is easily by gross appearance stoma like lesion, which is located just lateral of the umbilical cord, an intact omphalocele sac and post-natal meconium stool passage.
出生时卵黄管瘘（VF）合并脐膨出是一种罕见的先天性异常，是器官发生紊乱的结果，肠道未能正常返回腹腔，卵黄管闭塞失败。
一名新生儿表现为脐膨出囊，可见肠管，脐带外侧有类似造口的病变，黏膜脱垂，有胎粪排出。手术证实脐膨出囊完整且存在卵黄管瘘。采用小肠楔形切除术进行瘘管切除，并一期缝合腹壁缺损。
在我们查阅的文献中，尚未有与脐膨出相关的卵黄管瘘的报道。这种异常组合可能会造成误导，然而，通过观察脐膨出囊上卵黄管开口的位置（靠近脐带）以及出生后胎粪的排出情况，很容易做出诊断。瘘管造影可能是识别和确认瘘管通道的最佳初始诊断性影像学方法。
与脐膨出相关的卵黄管瘘很罕见。通过肉眼观察位于脐带外侧类似造口的病变、完整的脐膨出囊以及出生后胎粪排出情况，很容易在出生后做出诊断。
