Treatment of Internal Herniation due to Vitelline Vascular Remnants by Laparoscopic Surgery

Abstract

A 77-year-old man was urgently admitted to the hospital with complaints of abdominal pain and vomiting. Abdominal X-ray and CT revealed intestinal obstruction. At first, conservation therapy using an ileus tube was performed because of no ischemic change of the small intestine. The symptoms and intestinal expansion improved, but CT and upper gastrointestinal series showed persistent intussusception. Therefore, laparoscopic surgery was performed. Intraoperative findings showed a cord-like structure extending from the mesentery of the ileum, 50 cm proximal to the Bauhinʼs valve and adhering to the left medial umbilical fold. We considered the cord to be vitelline vascular remnants because of the running and macroscopic findings. We examined the small intestine, but there was no evidence of Meckelʼs diverticulum. We report this very rare case with some literature reviews.