An umbilical defect
During their caesarean delivery, one of three triplet fetuses, aged 31 weeks and 2 days, was noted to have a clear shiny sac protruding from the base of the umbilical cord. The defect was immediately covered with moist dressings, which upon removal had some green-yellow staining. Physical examination showed an intact membranous sac containing what seemed to be several loops of bowel. Upon closer inspection of the sac, a small stoma was discovered (figure).
The most common congenital anomaly of the small intestine is persistence of all or part of the omphalomesenteric duct. Complete persistence of the omphalomesenteric duct is rare, occurring in less than 6% of omphalomesenteric duct anomalies,2 and results in a patent tract between the ileal lumen and the outside of the body via the umbilicus. More commonly, in about 2% of the population and more than 98% of omphalomesenteric duct defects, the duct may partially obliterate