Patent vitelline duct in an adult deceptively appeared to be acquired umbilical urachal sinus: a case report

Abstract

40歳男.約10年前より臍からの液性分泌物に気付いていた.術前, 瘻孔造影を含めて諸検査により, 臍瘻を伴った後天性尿膜管洞の診断のもとに手術に着手したが, 開腹してみると卵黄腸管開存症であった.詳細に検索すると, この卵黄腸管は途中で180度の屈曲を有しており, この特異的な屈曲がその通過に対して留栓として作用していた為, 造影剤の腸管内流入と生来から腸管内容物の臍からの排出が妨げられ, 鑑別診断が不可能という結果に終わった.組織学的に絨毛上皮, 粘膜下固有層, 平滑筋層及び漿膜からなる, 完全な小腸壁の構造が認められた

Here is presented a surprisingly rare case in a 40-year-old male who had patent vitelline duct by nature. However, his congenital disease appeared deceptively to be an acquired umbilical urachal sinus on the diagnostic evaluations including fistulography before surgery. The diagnosis was definitely confirmed after the successful surgical procedure. The principal reason why these diseases were indistinguishable was reviewed. The incidence of each disease and incidence of association with umbilical fistula in each disease were discussed. With regard to these incidences, we compared urachal anomalies with vitelline duct anomalies through reference of several literatures. This is the most unique event we have ever clinically experienced.