Omphalomesenteric duct & Urachal remnant presentation in a newborn

Introduction: Persistent urachal anomalies are rare congenital pathologies caused by a failure of obliteration of the urachal remnant, whereas a patent omphalomesenteric duct is due to an incomplete obliteration of the vitelline duct. These congenital anomalies are rarely associated with one another. We describe a case of a newborn, presenting with an umbilical lump and on surgical exploration was found to have an omphalomesenteric duct and a urachal remnant. Case report: A 5- day old newborn presented to Accident and Emergency (A&E) with an umbilical lump, present since birth, with no other symptom. On clinical examination, a 3cm umbilical lump was noted, protruding from the umbilicus raising the suspicion of an umbilical granuloma or an omphalocele of the cord. In view of this, surgical exploration was undertaken and a patent urachus with an omphalomesenteric duct was visualised and both were excised. Conclusion: Our case underlines the importance of evaluating all persisting umbilical lesions without delay to be able to better assess the presenting symptoms.