Abstract
Introduction : Vitelline vessels are blood vessels feeding the primitive gut and the remnants of these vessels after birth are called mesodiverticular bands. We present a case of strangulation ileus caused by a mesodiverticular band.
Case : A 26-year-old man without previous history of undergoing laparotomy was seen at our hospital because of abdominal pain and vomiting. Abdominal CT scan showed remarkable dilatation and swelling of the small intestine, with a part suggestive of strangulation. Emergency operation was performed with a diagnosis of strangulation ileus. At laparotomy, we saw the small intestine to be incarcerated by a cord which extended from the abdominal wall to the intestine, resulting in strangulation ileus. The cord had originated from the mesentery about 80 cm proximal to the ileocecal region. The root of the cord was ligated and resected. Histopathological study revealed a ductal structure accompanied by congestion within the cord that was considered to be the mesodiverticular band.
Consideration : Meckel's diverticulum that is the mesodiverticular band occurs in about 2% of the population, among of which the mesodiverticular band is associated in an incidence of 1-6%. There are some reports describing that about half number of cases of the mesodiverticular bands are not associated with Meckel's diverticulum. In treating strangulation ileus in this patient who had no previous history of laparotomy, the mesodiverticular band appeared to be the probable cause.
