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Intestinal tissue in the umbilical cord
INTESTINAL
TISSUE
IN THE
UMBILICAL
CORD
A
S THE umbilical cord is formcti by thv I’lGon 01’ t hc ;\llani.()i(* stalk with part of the \,itello-intrstirl~~l duct and the remains of thv yolk sac, it might seem probable that intestinal tissw would, not, very int’w quently, be found in the umbilical cord (a misplawd Mcckcl ‘s diverticallIum?). No mention of this condition. howcvc~r~ has been found in an) of’ the considerable number of works on ohst~~tri~s and gynecology whic~h have been consulted. While no car&l1 search of tho litcratnrc has made, the finding of intestinal tissue h~rc~appears raw enough IO JYlllt
il
t)riPf
Fig, l.-Showing jelly which filled removed before
TTpOl’t
Of
Sllch
il
(‘;IS(‘.
the pircv of intestinal the space betwern this ant1 the photograph was takrn.
tissuv in the convex
the umbilical vortl. portion of the conI
Wh:~,~t<,ns was partI)-
A 19-year-old primipa’a ga\c hit*111 t,o iI I’ull-term infitrlt hy s]tOIltaneous delivery. It. was noted at the t irnc of dtlivery that. neat’ the midportion of the umbilical cord there was il IIMSS the size ol’ an orange, ovoid in shape. On cutting t,hrough the ottt t’l’ :);I 1.1 of this, thclrc> \\‘as some jelly-like substance, and also an clotigatd bwwnish street urv ;~boul 6 cm, in length which was thought to be snggosti\o of a teratoma,
BBRTLETT
AND
MARSHAK
:
INTESTINAL
TISSTJE
IN
UMBTLICAT,
CORD
10‘47
The As received at the laboratory, the placenta showed no pathology. umbilical cord was attached a short distance from t,he center. The cord measured 35 cm. in a straight line from end to end, but was longer than this because of a large bowing at one part,. The first 20 cm. from the placenta. was of medium size with the usual twists. Then came the bowing in the cord, about X cm. on the straight edge and 13 cm. around the convex portion. The cord was much thicker along this convex port,ion than it was at either end due to the thiekncss of Wharton’s jelly, which was so transparent that the umbilical vessels could be readily followed by transmitted light. They were larger here than elsewhere. The concave portion of this bow was filled by Wharton’s jelly which had separated into two layers, formin p the cystlikc space from which the mllcoid material came at the time of’ delivery.
Pig.
L-Section
showing
intestinal
tissue
in the
umbilical
co~xl.
Lying in the Whaxton’s jelly along the straight edge of the bow was a reddish brown structure, extending lengthwise of the cord (Fig. 1). This measured about 6 cm. in lenqth and nearly 2 rm. in transverse diameter, tapering somewhat at the ends. It wits a little irregular on On removing a small portion of this near the center it the surface. was found to haye a lumen containing a brownish amorphous substance. Microscopic examination of this piece showed the structure of small intestine ineluding all of the layers of the intestinal wall (Fig. 2). A near each end showed a similar structure. On small portion taken from opening the specimen lengthwise t,he lumen ~vds found to extend the entire length but was closed at, each end. If this intestinal structure had been on the other side of t,he u.nlbilicL!s, it presumably would huvr fo~~mrd ii Meckel’s c~ivc~~t,irrll\lnl.
TISSUE
IN THE
UMBILICAL
CORD
A
S THE umbilical cord is formcti by thv I’lGon 01’ t hc ;\llani.()i(* stalk with part of the \,itello-intrstirl~~l duct and the remains of thv yolk sac, it might seem probable that intestinal tissw would, not, very int’w quently, be found in the umbilical cord (a misplawd Mcckcl ‘s diverticallIum?). No mention of this condition. howcvc~r~ has been found in an) of’ the considerable number of works on ohst~~tri~s and gynecology whic~h have been consulted. While no car&l1 search of tho litcratnrc has made, the finding of intestinal tissue h~rc~appears raw enough IO JYlllt
il
t)riPf
Fig, l.-Showing jelly which filled removed before
TTpOl’t
Of
Sllch
il
(‘;IS(‘.
the pircv of intestinal the space betwern this ant1 the photograph was takrn.
tissuv in the convex
the umbilical vortl. portion of the conI
Wh:~,~t<,ns was partI)-
A 19-year-old primipa’a ga\c hit*111 t,o iI I’ull-term infitrlt hy s]tOIltaneous delivery. It. was noted at the t irnc of dtlivery that. neat’ the midportion of the umbilical cord there was il IIMSS the size ol’ an orange, ovoid in shape. On cutting t,hrough the ottt t’l’ :);I 1.1 of this, thclrc> \\‘as some jelly-like substance, and also an clotigatd bwwnish street urv ;~boul 6 cm, in length which was thought to be snggosti\o of a teratoma,
BBRTLETT
AND
MARSHAK
:
INTESTINAL
TISSTJE
IN
UMBTLICAT,
CORD
10‘47
The As received at the laboratory, the placenta showed no pathology. umbilical cord was attached a short distance from t,he center. The cord measured 35 cm. in a straight line from end to end, but was longer than this because of a large bowing at one part,. The first 20 cm. from the placenta. was of medium size with the usual twists. Then came the bowing in the cord, about X cm. on the straight edge and 13 cm. around the convex portion. The cord was much thicker along this convex port,ion than it was at either end due to the thiekncss of Wharton’s jelly, which was so transparent that the umbilical vessels could be readily followed by transmitted light. They were larger here than elsewhere. The concave portion of this bow was filled by Wharton’s jelly which had separated into two layers, formin p the cystlikc space from which the mllcoid material came at the time of’ delivery.
Pig.
L-Section
showing
intestinal
tissue
in the
umbilical
co~xl.
Lying in the Whaxton’s jelly along the straight edge of the bow was a reddish brown structure, extending lengthwise of the cord (Fig. 1). This measured about 6 cm. in lenqth and nearly 2 rm. in transverse diameter, tapering somewhat at the ends. It wits a little irregular on On removing a small portion of this near the center it the surface. was found to haye a lumen containing a brownish amorphous substance. Microscopic examination of this piece showed the structure of small intestine ineluding all of the layers of the intestinal wall (Fig. 2). A near each end showed a similar structure. On small portion taken from opening the specimen lengthwise t,he lumen ~vds found to extend the entire length but was closed at, each end. If this intestinal structure had been on the other side of t,he u.nlbilicL!s, it presumably would huvr fo~~mrd ii Meckel’s c~ivc~~t,irrll\lnl.