A Case of Mesodiverticular Band Causing Small Intestinal Obstruction / 대한소아소화기영양학회지

Meckel's diverticulum is found in about 3% of the population, often incidentally during laparotomy or at autopsy. Over 50% of patients who develop symptoms from this anomaly are younger than 2 years of age. The most common symptom of this lesion is intestinal obstruction. Rarely Meckel's diverticulum is complicated by a mesodiverticular band, which is believed to be a remnant of a vitelline artery. We report a 11-year-old girl with small bowel obstruction because of an intestinal hernia beneath the mesodiverticular band. The causative factor was a stenotic area in the terminal ileum caused by a ringlike lipovascular mesenteric band encroaching externally on the lumen. Although the incidence of mesodiverticular bands complicating Meckel's diverticulum is quite low, the rapid clinical course and the associated high mortality rate make this an important disease.

A Clinical Study of Vitelline Duct and Vessel Remnants

Of 72 cases with vitelline duct and vessel remnants, 45 (62.5%) had symptomatic lesions (mean age, 27.9 months) with male preponderance (4.6: 1). Among the 45 symptomatic lesions, there were 22 cases of Meckel's diverticulum, 6 cases of Meckel's diverticulum with fibrous band attached to the umbilicus, 6 cases of patent vitelline duct, 5 cases of vitelline artery remnant as fibrous band, 2 cases of umbilical sinus, 2 cases of umbilical polyp, and 2 cases of vitelline cyst. Twenty three cases (51%) presented with intestinal obstruction, 6 (13%) with rectal bleeding, 4 (9%) with perforated Meckel's diverticulum, 5 with intestinal fluid drainage through umbilicus, 5 with umbilical lesion, and 1 with abdominal mass. Intestinal obstruction due to fibrous band developed at infancy (average age, 4.6 months). About 82% of complicated Meckel's diverticulum (n=28) presented less than 4 years of age. Seventeen Meckel's diverticulums, 8 obliterated vitelline artery remnants, and 1 vitelline vein remnant as fibrous band were found incidentally at laparotomy.

Patent Omphalomesenteric Duct Remnants: Report of 4 Cases

The omphalomesenteric duct normally obliterates by the sixth week of intrauterine life. Incomplete obliteration results various abnormalities which may be apparent in the newborn infant. The omphalomesenteric duct may persist as an omphalomesenteric fistula. Morphologically the fistula resembles the ileum, but may contain ectopic gastric, colonic or pancreatic tissue. The infant presents with an umbilical discharge which may be recognizable as small bowel content. Although this malforamtion should be recognizable at birth, 40% of patients are not treated until after the first month of life. In the past 28 months since the Samsung Medical Center opened its doors to public, the authors experienced 4 cases of patent omphalomesenteric duct remnant including one case of T-shaped total prolapse of duct and adjacent ileum. These cases will be discussed with literature review.