Persistent omphalomesenteric duct: a rare cause of acute intestinal volvulus in an adolescent treated by laparoscopy
This report describes the case of a 14-year-old male with a prior history of recurrent abdominal pain and two previous sub-occlusive episodes. He presented at the Emergency Room with abdominal pain, emesis, abdominal distension, painful palpation, and signs of peritoneal irritation. Plain upright abdominal radiography suggested a distal small bowel obstruction. Exploratory laparoscopy showed a tubular structure connecting the antimesenteric border of the terminal ileum and the umbilicus, which was behaving as a rotation axis to the small intestine. The volvulus was laparoscopically de-rotated, and the structure was excised. Histological exam confirmed the diagnosis of persistent omphalomesenteric duct. This case illustrates an intestinal obstruction caused by small intestine volvulus. A high index of suspicion is required to acknowledge this etiology.
Main Authors: | , , , , , |
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Format: | Digital revista |
Language: | English |
Published: |
Centro Hospitalar do Porto
2019
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Online Access: | http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-07542019000200008 |
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Summary: | This report describes the case of a 14-year-old male with a prior history of recurrent abdominal pain and two previous sub-occlusive episodes. He presented at the Emergency Room with abdominal pain, emesis, abdominal distension, painful palpation, and signs of peritoneal irritation. Plain upright abdominal radiography suggested a distal small bowel obstruction. Exploratory laparoscopy showed a tubular structure connecting the antimesenteric border of the terminal ileum and the umbilicus, which was behaving as a rotation axis to the small intestine. The volvulus was laparoscopically de-rotated, and the structure was excised. Histological exam confirmed the diagnosis of persistent omphalomesenteric duct. This case illustrates an intestinal obstruction caused by small intestine volvulus. A high index of suspicion is required to acknowledge this etiology. |
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