Disorders of the omphalo-mesenteric duct (Meckel's diverticulum)

In fetal life the intestinal tract and the yolk sac are joined by the omphalo-mesenteric or vitelline duct. Remnants of this may persist and present as: (1) A persistent discharge from the umbilicus which is occasionally faecal. (2) Gastro-intestinal bleeding from ectopic gastric mucosa in Meckel's diverticulum. (3) Gut obstruction caused by gut twisting around a persistent vitelline duct, as described in Section 28.3. You may occasionally have to resect and anastomose gut in connection with any of these three, or, rarely, with the other abnormalities in Fig. 28-4.

Fig 28-5 ANORECTAL MALFORMATIONS. Low lesions go below the puborectalis sling, high ones remain above it. You should be able to treat the low ones without too much difficulty. You will have to do a colostomy and refer the high ones. Adapted from Ravitch et al., ''Paediatric Surgery', Fig. 98-2. Yearbook Medical, with kind permission.