Chronic ileal obstruction in adults due to peri-ileal vitelline vascular remnants

Two young adults had distal ileal obstruction at sites where a fold of mesentery extended from its posterior leaf to the antimesenteric border of the bowel. No Meckel's diverticulum or mesoumbilical band was present in either case. Clinical, gross and microscopic findings suggested that the mesenteric fold represented a remnant of vitelline vessel that persisted in the peri-ileal portion of its course. Chronic ileal obstruction was apparently due to disordered peristalsis caused by the fold tethering the adjoining posterior bowel wall. In one patient, a chronic ulcer at the site of obstruction was interpreted as being an additional complication of the congenital lesion.