It is quite unusual for a fistula to communicate directly with the surface of the hernia sac, and associated prolapse of the ileum through a patent omphalomesenteric duct is also extremely rare.We report a unique case of a fetus exposed to methimazole in utero, with a hernia of the umbilical cord and associated ileal prolapse through a patent omphalomesenteric duct.In this case, the umbilical cord was attached to a small unruptured omphalocele, to the right of which a small everted loop of the ileum had evaginated. The hernia sac measured 2.5 cm and contained only ileum. The ileal prolapse was T shaped and had two visible mucosal ostia, and meconium was discharging from the ostium on the oral side. We confirmed that this loop of small bowel had prolapsed through a patent omphalomesenteric duct, which had a fistulous communication with the surface of the hernia sac. This resulted in the misleading prenatal findings on ultrasound and MRI, which were suggestive of a gastroschisis. Such a case with prenatal ultrasound and MRI findings has not been reported previously.The observed congenital anomaly in our fetus might be associated with prenatal exposure to methimazole.

作者：Kyoko, Ono；Akihiko, Kikuchi；Keiko Miyachi, Takikawa；Takehiko, Hiroma；Katsumi, Yoshizawa；Sorahiro, Sunagawa；Kimiyo, Takagi；Yoshitaka, Momose；Tomohiko, Nakamura

来源：Fetal diagnosis and therapy 2009 年 25卷 1期