Concurrent omphalomesenteric duct cyst and ileal diverticulum causing small bowel obstruction; a case report

Area of Science:

• Gastroenterology
• Pediatric Surgery
• Surgical Pathology

Background:

• The omphalomesenteric duct (OMD) typically involutes by the ninth gestational week.
• Failure of OMD obliteration can lead to various pathologies, most commonly in pediatric patients.
• Omphalomesenteric cysts are rare OMD remnants, and their co-occurrence with Meckel's diverticulum is exceptionally uncommon.

Purpose of the Study:

• To present a rare case of concurrent omphalomesenteric cyst and ileal diverticulum (Meckel's diverticulum).
• To discuss the diagnostic and management implications of this rare concurrence, which can lead to internal hernia and bowel obstruction.

Main Methods:

• Case presentation of an adolescent patient with symptoms of nausea, vomiting, and abdominal pain.
• Diagnostic workup including imaging to identify the cause of bowel obstruction.
• Surgical intervention for internal hernia and bowel obstruction caused by concurrent OMD remnants.

Main Results:

• The patient was diagnosed with a concurrent omphalomesenteric cyst and ileal diverticulum.
• The condition resulted in internal hernia and bowel obstruction, requiring surgical correction.
• The rare concurrence necessitates careful surgical planning and potentially more extensive resection.

Conclusions:

• Preoperative imaging is crucial for diagnosing bowel obstruction and identifying the underlying cause, such as OMD remnants.
• The presence of a periumbilical cyst should raise suspicion for OMD remnants, especially in young adults with prior episodes of abdominal pain and obstruction.
• Familiarity with the rare concurrence of omphalomesenteric cysts and Meckel's diverticulum enhances surgical preparedness.