A rare case report of patent vitellointestinal duct with prolapsed orthograde ileal intussusception seen as bident horn

Introduction and importance: Patent vitellointestinal duct (PVID) with prolapsed bowel is an extremely rare congenital anomaly. Even rarer is the presentation with orthograde ileal intussusception. Case presentation: We report a 16-day-old neonate with a “Y”-shaped, red, mucosal mass protruding from the umbilicus, resembling a bident horn. Clinical examination revealed a prolapsed loop of ileum through a PVID without signs of obstruction or systemic sepsis. After stabilization with intravenous fluids, antibiotics, and thermal support, the patient underwent emergency laparotomy. Operative findings revealed prolapsed orthograde ileal intussusception through a PVID with unhealthy bowel. Resection of the duct and unhealthy segment was performed, followed by primary ileoileal anastomosis. The postoperative course was uneventful, and the infant remained asymptomatic at 3-month follow-up. Clinical discussion: Complete patency of VID with prolapsed orthograde intussusception is exceptionally rare, especially in neonates. The absence of systemic sepsis despite delayed presentation may be due to partial or intermittent intussusception with preserved bowel perfusion. The bident horn-like umbilical appearance represents a distinct clinical presentation. Surgical management requires prompt resection and anastomosis to prevent complications. Conclusion: This case highlights a unique presentation of PVID with orthograde ileal intussusception. Early recognition and timely surgical management are essential to achieve excellent outcomes, even in resource-limited settings.