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[Intra-abdominal ligament remnants of the vitelline duct and vessels]
Insights
Congenital intraabdominal bands, often from vitelline vessel remnants, frequently cause acute abdominal disease. Early surgical intervention is crucial for treating intestinal strangulation and preventing complications like gangrene and endotoxin shock.
Area of Science:
- Pediatric Surgery
- Gastrointestinal Surgery
- Congenital Abnormalities
Context:
- Intraabdominal bands arising from vitelline vessel and duct remnants represent a congenital anomaly.
- These anomalies can manifest at any age but commonly present as acute abdominal disease, affecting over 75% of individuals.
- This study reviews 19 pediatric cases and 83 literature cases to elucidate the etiology and clinical presentation.
Purpose:
- To analyze the causes and clinical manifestations of intraabdominal bands originating from vitelline remnants.
- To highlight the high incidence of acute abdominal disease associated with these congenital disturbances.
- To emphasize the critical role of prompt surgical management.
Summary:
- Remnants of the vitelline artery (70%) and vitelline vein/duct (33%) are frequently identified as the source of these intraabdominal bands.
- The typical clinical course involves acute intestinal strangulation, leading to bowel gangrene and endotoxin shock.
- Surgical intervention is the recommended treatment to address the acute condition and prevent severe outcomes.
Impact:
- Provides insights into the pathogenesis and clinical spectrum of vitelline remnant-associated intraabdominal bands.
- Underscores the importance of timely diagnosis and surgical intervention in pediatric acute abdomen cases.
- Contributes to the understanding of congenital gastrointestinal anomalies and their surgical management.
Abstract:
Intraabdominal bands of the vitelline vessels and vitelline duct are discovered as a congenital disturbance any time in life. In more than 75% they cause an acute abdominal disease. In this paper we discuss the cause and the clinical picture in 19 children seen in our department together with 83 cases from the literature. In 70% of the cases we find remnants of the right and left vitelline artery, in a third remnants of the vitelline vein and vitelline duct. The characteristic course is the acute strangulation of the intestine with gangrene of the bowel and endotoxine shock. The best treatment in every case is the operation as soon as possible.