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Small bowel obstruction secondary to band formation by an omphalomesenteric cyst - A case report

Rukma Raj Kafle1, Rakshya Arun Kandel1, Anupam Bhandari2

  • 1Department of Emergency Medicine, Scheer Memorial Adventist Hospital (SMAH), Banepa 45210, Nepal.

International Journal of Surgery Case Reports
|August 8, 2025
PubMed

Insights

Omphalomesenteric duct (OMD) remnants can cause rare small bowel obstructions in healthy individuals. Early diagnosis via imaging and surgical resection are key for symptomatic cases.

Area of Science:

  • Embryology
  • Gastroenterology
  • Surgical Pathology

Background:

  • The omphalomesenteric duct (OMD) is a vital embryonic structure connecting the midgut to the yolk sac, typically obliterating by the 18th week of gestation.
  • Persistence of the OMD can lead to various congenital anomalies, including omphalomesenteric duct cysts and fibrous bands.

Observation:

  • A rare case of a 14-year-old male presenting with acute abdominal pain and vomiting due to small bowel obstruction caused by an OMD remnant fibrous band.
  • Initial ultrasonography suggested mesenteric lymphadenitis, while CT revealed dilated small bowel with obstruction and wall thickening.

Findings:

  • Exploratory laparotomy identified and resected an OMD remnant fibrous band causing small bowel obstruction 20 cm proximal to the ileocecal valve.
  • Pathological examination confirmed the fibrous band as an omphalomesenteric duct remnant.

Implications:

  • Omphalomesenteric duct remnants, though rare, must be considered in the differential diagnosis of small bowel obstruction, particularly in patients without prior surgical history.
  • While asymptomatic remnants may not require intervention, symptomatic cases necessitate surgical management for effective treatment and prevention of complications.
Abstract

Keywords:
Band formationCase reportMesenteric lymphadenitisOmphalomesenteric cystPediatric ageSmall bowel obstruction

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