A rare case of pediatric volvulus caused by a persistent omphalomesenteric cyst
Keywords:Acute abdomen, Intestinal volvulus, Omphalomesenteric duct
A persistent omphalomesenteric duct is one possible cause of small-bowel volvulus, a rare cause of acute abdomen in children. A four-year-old child was admitted to the Emergency Department with abdominal pain and incoercible vomiting, with neither abdominal guarding nor relevant abnormalities revealed in complementary diagnostic exams. Due to a significant clinical deterioration over a 48-hour observation period, the child was transferred to a tertiary hospital with pediatric surgery. An abdominal ultrasound revealing severe bowel distension and increased abdominal free fluid warranted an exploratory surgery, which identified a voluminous omphalomesenteric duct cyst. When symptomatic, treatment of this condition is consensual and consists of surgical excision of the anatomical abnormality, either by laparoscopy or conventional surgery. The latter was performed.
Conclusion: A persistent omphalomesenteric duct is a rare condition that generally requires a high level of clinical suspicion for diagnosis to be made, being most commonly detected during surgery. Associated complications and mortality rates are high, and a timely intervention is key, since surgical removal is the only treatment option.
Vijayaraghavan SB, Ravikumar VR, Srimathy G. Whirlpool Sign in Small-Bowel Volvulus Due to a Mesenteric Cyst. J Ultrasound Med 2004; 23: 1375-1377.
Giacalone G, Vanrykel JP, Belva F, Aelvoet C, De Weer F, Van Eldere S. Surgical Treatment of Patent Omphalomesenteric Duct Presenting as Faecal Umbilical Discharge. Actachirbelg 2004; 104: 211-213.
Ioannidis O, Paraskevas G, Kakoutis E, Kotronis A, Papadimitriou N, Chatzopoulos S, et al. Coexistence of Multiple Omphalomesenteric Duct Anomalies. Journal of the College of Physicians and Surgeons Pakistan 2012; 22(8): 524-526.
Zafer Y, Yiğit Ş, Türken A, Tekinalp G. Patent Omphalomesenteric Duct. Turk J Med Sci 2000; 30: 83-85.
Neyak B, Dash RR, Mallik BN. Multiple vitello-intestinal duct anomalies in a pediatric patient: A rare case report. Oncology, Gastroenterology and Hepatology Reports 2015; 4(1): 30-31.
Mariño LP, Fraga JI, Rubio S, Segarra J, Gaetar M, Ossés JA. Persistencia del conductoonfalomesentérico. Arch Argent Pediatr 2009; 107(1): 57-59.
Ccencho CG, Cydejko JCL, Aranguren CFG, Revoredo F, Tarazona AS, Ramírez VO. Persistencia de ConductoOnfalomesentéricocomocausa de Obstruccion Intestinal en el Adulto. Reporte de un caso en el Hospital Nacional Hipolito Unanue. Rev Gastroenterol Perú 2008; 28: 154-157.
Herman M, Gryspeerdt S, Kerckhove D, Matthijs I, Lefere P. Small Bowel Obstruction due to a Persistent Omphalomesenteric Duct. JBR-BTR 2005; 88: 175-177.
Mahato NK. Obliterated, fibrous omphalo-mesenteric duct in an adult without Meckel’s diverticulum or vitelline cyst. Romanian Journal of Morphology and Embryology 2010; 51(1): 195-197.
Markogiannakis H, Theodorou D, Toutouzas KG, Drimousis P, Panoussopoulos SG, Katsaragakis S. Persistent omphalomesenteric duct causing small bowel obstruction in an adult. World J Gastroenterol 2007; 13(15): 2258-2260.
How to Cite
Copyright and access
This journal offers immediate free access to its content, following the principle that providing free scientific knowledge to the public provides greater global democratization of knowledge.
The works are licensed under a Creative Commons Attribution Non-commercial 4.0 International license.
Nascer e Crescer – Birth and Growth Medical Journal do not charge any submission or processing fee to the articles submitted.