J Am Acad Dermatol 2019 Feb 21. Epub 2019 Feb 21.
Laser Unit, Department of Dermatology, Rabin Medical Center, Petach-Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
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.