A Prolapsing Vitello-intestinal Duct in Newborn

Pediatrician attending to a newborn delivered by emergency cesarean section observed a red coloured mass protruding from the umbilicus by the side of umbilical cord. Pediatric surgeon was called for opinion. Pediatrician had tied the umbilical cord with a sterile thread rather than usual umbilical clamp. It was a full term male baby with a patent vitello-intestinal duct (VID) and a prolapsing proximal and distal intestinal loop giving shape of an inverted Y (Fig. 1). Meconium was seen coming from one of the limbs of the Y. Antenatal checkup and all antenatal ultrasound scans were reported as normal. Patient was kept under observation and planned for early intervention. Under general anesthesia, prolapsed loop was approached through circum-umbilical incision at mucocutaneous junction after reducing the prolapsed part. Intestine was delivered outside the abdomen; vitellointestinal duct opening was in distal ileum as opening was too wide so that resection and anastomosis was done. Intestine replaced inside the abdomen and umbilicoplasty was done with absorbable sutures. Postoperative period was uneventful and patient discharged on 5th postoperative day.