Persistent omphalomesenteric duct: a rare cause of acute intestinal volvulus in an adolescent treated by laparoscopy

  • Maria Miguel Gomes Department of Pediatrics, Hospital de Braga
  • Catarina Faria Department of Pediatrics, Hospital de Braga
  • Manuela Costa Alves Department of Pediatrics, Hospital de Braga
  • Ana Raquel Silva Department of Pediatric Surgery, Hospital de Braga; Life and Health Sciences Research Institute; School of Health Sciences, University of Minho and Portugal Government Associate Laboratory ICVS/ 3B’s
  • Jorge Correia Pinto Department of Pediatric Surgery, Hospital de Braga; Life and Health Sciences Research Institute; School of Health Sciences, University of Minho and Portugal Government Associate Laboratory ICVS/ 3B’s
  • Angélica Osório Department of Pediatric Surgery, Hospital de Braga; Life and Health Sciences Research Institute; School of Health Sciences, University of Minho and Portugal Government Associate Laboratory ICVS/ 3B’s
Keywords: omphalomesenteric duct, vitelline duct, laparoscopy, small intestinal obstruction, volvulus

Abstract

This report describes the case of a 14-year-old male with a prior history of recurrent abdominal pain and two previous ”sub-occlusive” episodes. He presented at the Emergency Room with abdominal pain, emesis, abdominal distension, painful palpation, and signs of peritoneal irritation. Plain upright abdominal radiography suggested a distal small bowel obstruction. Exploratory laparoscopy showed a tubular structure connecting the antimesenteric border of the terminal ileum and the umbilicus, which was behaving as a rotation axis to the small intestine. The volvulus was laparoscopically de-rotated, and the structure was excised. Histological exam confirmed the diagnosis of persistent omphalomesenteric duct.
This case illustrates an intestinal obstruction caused by small intestine volvulus. A high index of suspicion is required to acknowledge this etiology.

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Published
2019-07-18
Section
Case Reports