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Persistent omphalomesenteric duct causing small bowel obstruction in an adult
Vikas Maheshwari1, T S Ramakrishnan1, Vikram Trehan1
1Indian Air Force, 92/1,Doctors Enclave, Nathu Singh Road, Kanpur Cantt, 208004 India.
The Indian Journal of Surgery
|January 16, 2014
Summary
Persistent omphalomesenteric duct (a congenital anomaly) can cause intestinal obstruction in adults. Surgical resection of the affected ileum and Meckel
Area of Science:
- Gastroenterology and Hepatology
- Surgical Sciences
- Pediatric Surgery (in adults)
Background:
- The omphalomesenteric duct (OMD) normally obliterates during fetal development.
- Persistence of the OMD can lead to various congenital anomalies, most commonly Meckel's diverticulum.
- While typically diagnosed in childhood, OMD remnants can present atypically in adulthood.
Purpose of the Study:
- To report an uncommon case of adult intestinal obstruction caused by a persistent omphalomesenteric duct.
- To highlight the diagnostic and surgical considerations for this rare adult presentation.
Main Methods:
- Case report of a middle-aged adult patient presenting with symptoms of intestinal obstruction.
- Diagnostic workup including exploratory laparotomy.
- Surgical intervention involving resection of the affected ileal segment and anastomosis.
Main Results:
- Exploratory laparotomy confirmed a persistent omphalomesenteric duct as the cause of terminal ileum obstruction.
- A Meckel's diverticulum and a gangrenous segment of the ileum were identified and resected.
- Successful end-to-end anastomosis was performed.
Conclusions:
- Persistent omphalomesenteric duct is a rare but significant cause of intestinal obstruction in middle-aged adults.
- Early surgical intervention is crucial for managing complications like bowel obstruction and gangrene.
- This case underscores the importance of considering congenital anomalies in the differential diagnosis of adult intestinal obstruction.
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