Fistule omphalo-msentrique ( propos dun cas)

Introduction: La fistule omphalo-mesenterique est une anomalie congenitale tres rare. Nous rapportons les aspects cliniques et radiologiques d’un cas observe dans le service de pediatrie du Centre Hospitalier Universitaire Sylvanus Olympio de Lome. Observation: un nourrisson de trois mois, ancien premature de 31 semaines d’amenorrhee, a presente depuis la naissance un ecoulement de liquide intestinal puis plus tard de selles par l’ombilic. L’examen local a montre une tumefaction ombilicale inflammatoire au sein de laquelle existait un pertuis catheterisable. Une fistulographie faite a permis d’objectiver la persistance d’un canal omphalo-mesenterique et de retenir le diagnostic de fistule omphalo-mesenterique. Discussion: La fistule omphalo-mesenterique est une affection tres rare. Son diagnostic repose sur l’examen clinique et les donnees de la fistulographie. De rare cas de regression spontanee apres la naissance ont ete decrits, mais le traitement curatif demeure chirurgical. Conclusion: Le diagnostic de la fistule omphalo-mesenterique doit se faire dans la periode neonatale pour une prise en charge precoce. Mots cles: Fistule omphalo-mesenterique, Lome, Togo English Title:  Patent omphalomesenteric duct (a case report) English Abstract Introduction: Patent omphalomesenteric duct is a very rare congenital anomaly. We report the clinical and radiological aspects of a case observed in the pediatric department of the Lome University Hospital Sylvanus Olympio. Observation: A three-month-old infant, a preterm infant of 31 weeks of amenorrhea, had a flow of intestinal fluid and later stools through the umbilicus. The local examination showed an inflammatory umbilical swelling within which there was a catheterizable lumen. Fistulography had made it possible to objectify the persistence of an omphalomesenteric canal and to retain the diagnosis of a patent omphalomesenteric duct. Discussion: Patent omphalomesenteric duct is a very rare disease. Its diagnosis is based on clinical examination and fistulography data. Of rare cases of spontaneous regression after birth have been described, but the curative treatment remains surgical. Conclusion: The diagnosis of a patent omphalomesenteric duct should be made in the neonatal period for early management. Keywords: Patent omphalomesenteric duct; Omphalomesenteric fistula; Lome; Togo