Cutaneous presentations of omphalomesenteric duct remnant: a systematic review of the literature

Abstract Background Disorders of the umbilicus are commonly seen in infancy including: hernias, infections, anomalies, granulomas and malignancies. Meticulous inspection of the umbilicus at birth may reveal a persisting embryonic remnant such as omphalomesenteric duct (OMD), manifested by a variety of cutaneous signs such as: an umbilical mass, granulation tissue or discharge. Objective To systematically review the available data regarding the presence and management of OMD remnant with cutaneous involvement, in order to suggest a practical approach for diagnosis and treatment. Methods A systematic review of the literature evaluating OMD anomalies presenting with cutaneous symptoms was performed. Additionally, an index case of an 11-months-old patient is presented. Results 59 publications were included, reporting 536 cases. 97% of the patients whose age was noted were infants (mean age, 11 months). In 7.5% of the cases diagnosis was established only after treatment failure. In 6.4 % of the patients non-lethal complications were reported, and in 10.3% the outcome was death, partly due to delayed diagnosis or mismanagement. Limitations Limited quality of the collected data, reporting bias. Conclusions OMD is relatively rare; however the clinician must consider it while examining patients with umbilical abnormalities, since mismanagement could cause severe morbidity and mortality.