Umbilical cord ulceration and intestinal atresia

A rare congenital condition involving the umbilical cord and intestines

Umbilical cord ulceration and intestinal atresia is a rare congenital condition characterized by the presence of an ulceration in the umbilical cord and an associated intestinal atresia, which is a blockage or absence of a portion of the intestine. This condition can lead to significant complications in the neonate and requires prompt medical attention.

Pathophysiology

The exact cause of umbilical cord ulceration and intestinal atresia is not fully understood. However, it is believed to result from a vascular accident during fetal development. The ulceration of the umbilical cord may lead to hemorrhage and compromise the blood supply to the developing intestine, resulting in atresia. The condition is often associated with other congenital anomalies, including gastroschisis and omphalocele.

Clinical Presentation

Infants with this condition typically present with signs of intestinal obstruction shortly after birth. Symptoms may include:

• Bilious vomiting
• Abdominal distension
• Failure to pass meconium

The ulceration of the umbilical cord may be visible at birth, and there may be evidence of bleeding from the cord stump.

Diagnosis

Diagnosis is usually made based on clinical presentation and confirmed with imaging studies. An abdominal X-ray may show signs of intestinal obstruction, such as dilated bowel loops and air-fluid levels. An ultrasound or MRI may be used to further evaluate the extent of the atresia and any associated anomalies.

Management

The management of umbilical cord ulceration and intestinal atresia involves surgical intervention to correct the intestinal atresia. This typically involves resection of the atretic segment and anastomosis of the healthy bowel ends. In cases of significant umbilical cord ulceration, careful management of the umbilical stump is necessary to prevent infection and further complications.

Postoperative care includes nutritional support, often with total parenteral nutrition (TPN), until the infant can tolerate enteral feeding. Long-term follow-up is necessary to monitor for complications such as short bowel syndrome and intestinal failure.

Prognosis

The prognosis for infants with umbilical cord ulceration and intestinal atresia depends on the severity of the condition and the presence of any associated anomalies. With prompt surgical intervention and appropriate postoperative care, many infants can achieve good outcomes. However, complications such as intestinal failure and growth retardation may occur.

Related Pages

• Intestinal atresia
• Umbilical cord
• Congenital anomalies
• Neonatal surgery