Open AccessComplexities of an uncomplicated symptom: two cases of umbilical discharge
Author(s) -
Nitin Agarwal,
Nikhil Gupta,
Manu Vats,
Mradul Garg
Publication year - 2020
Publication title -
bmj case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.231
H-Index - 26
ISSN - 1757-790X
DOI - 10.1136/bcr-2020-235604
Subject(s) - medicine , exploratory laparotomy , surgery , umbilicus (mollusc) , peritonitis , fistula , bowel obstruction , perforation , fistulectomy , laparotomy , meckel's diverticulum , surgical emergency , diverticulum (mollusc) , materials science , punching , metallurgy
A 10-year-old boy presented with a low volume feculent umbilical discharge associated with fever and anorexia. Exploratory laparotomy revealed a complex fistula communicating with multiple small bowel loops and extensive peritoneal nodules with caseous mesenteric lymph nodes; suggestive of abdominal tuberculosis. Fistulectomy, adhesiolysis and a diversion jejunostomy were done and antituberculosis therapy was started. A 20-year-old man presented with serous umbilical discharge, having a history of similar complaints in his infancy. While he was being investigated, he developed peritonitis and had to be operated on emergency basis. An umbilical sinus connected with a fibrous band to Meckel diverticulum and a proximal closed loop small bowel obstruction perforation were found. Resection and anastomosis of the affected segment were done, and the patient recovered well.