Question
A 3-month old baby girl presents with a swollen umbilicus that has failed to heal normally. The umbilicus drains secretions, and there is passage of fecal material through the umbilicus at times. What is the most likely diagnosis?
| A. |
Omphalocele
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| B. |
Gastroschisis
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| C. |
Anal agenesis
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| D. |
Ileal diverticulum
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Show Answer
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Correct Answer � D
Explanation
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Answer D) Ileal diverticulum
This baby girl has an ileal diverticulum (Meckel diverticulum), which occurs when a remnant of the vitelline duct persists. In this case, a fistula is present by which contents of the ileum can be discharged onto the surface of the skin.
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Meckel’s diverticulum is an outpouching or bulge in the lower part of the small intestine.
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The bulge is congenital (present at birth) and is a leftover of the umbilical cord.
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Meckel’s diverticulum is the most common congenital defect of the gastrointestinal tract.
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In Meckel’s diverticulum, the proximal part of vitelline duct fails to regress and involute, which remains as a remnant of variable length and location. The solitary diverticulum lies on the antimesenteric border of the ileum (opposite to the mesenteric attachment) and extends into the umbilical cord of the embryo.
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The left and right vitelline arteries originate from the primitive dorsal aorta, and travel with the vitelline duct. The right becomes the superior mesenteric artery that supplies a terminal branch to the diverticulum, while the left involutes.
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Having its own blood supply, Meckel’s diverticulum is susceptible to obstruction or infection.
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