Patent VitellointestinalDuct causing bowel obstruction in an Adolescent patient- A rare case report
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2019, Vol 18, Issue 4
Abstract
The omphalomesenteric duct(OMD) more commonly referred as vitelline duct/ vitellointestinal duct is a remnant of the embryonic yolk sac and is considered a very unusual congenital anomaly occurring in less than 2% of population where it persists as embryonic yolk stalk. Patent vitellointestinal duct causing intestinal obstruction is a very rare condition in an adolescent patient. We have reported an extremely uncommon case of persistent vitellointestinal duct uncommonly causing small intestinal obstruction in an adolescent age group where exploratory laparotomy was performed which showed dilated jejunum and proximal ileum with collapsed distal ileum because of a presence of a unobliterated vitelline duct extending from the anti-mesenteric border of the ileum around 95 cms from ileocolic junction to the posterior wall of the umbilicus was noted with twisting of distal loop.Omphalomesentric duct remnants being congenital are associated with the primitive yolk stalk which normally becomes a thin fibrous band, and eventually disintegrates and is absorbed spontaneously by 5th -9th week of gestation. Any failure in disintegration and absorption may lead to growing of the duct resulting in various anomalies as: Meckel’s diverticulum(most common), patent omphalomesentric duct or umbilicoileal fistula,umbilical sinus, umbilical cyst, umbilical mucosal polyp or a fibrous cord connecting the ileum to the umbilicus. In the reported case, since there was no history of previous abdominal operation and no resolution of the obstruction or improvement of the clinical picture of the patient was observed after a trail of conservative management, an operative intervention was decided. It should be kept in mind as a possible cause, in young patients presenting with acute mechanical small bowel obstruction without any previous history of surgery. Immediate intervention is to be implemented in order to reduce the mortality and morbidity.
Authors and Affiliations
Dr Aishwarya Avnish, Dr Saguna Pandit
Keywords
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- EP ID EP572196
- DOI 10.9790/0853-1804035963.
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