Abstract
The patient was a male infant, the second of monochorionic diamniotic twins born after 35 weeks and 5 days of gestation and weighing 1,938 g. His mother underwent amniotic fluid assessment in early pregnancy because of delayed childbearing. At delivery, he had a defect of the abdominal wall (0.5 cm in diameter) located lateral and superior to the umbilicus on the left, through which a bandlike tissue mass (approximately 2 cm in length) protruded. Meconium was seen shortly after birth. On day 1 of life, simple radiographs of the chest and abdomen showed no abnormal findings; the properties of the prolapsed tissue were unclear. However, on day 2, he underwent surgery after a diagnosis of abdominal wall rupture. Laparoscopic examination confirmed that the prolapsed tissue was a tip of the greater omentum derived from the transverse colon, which did not communicate with the bowel, and was followed by an open surgery with transverse incision centered on the defect of the abdominal wall. The defect was located in the left rectus abdominis, penetrating through all the layers of the abdominal wall. This suggested the localized abnormal formation of the abdominal wall. Abdominal wall incision, in addition to the lacuna, was simply closed after the partial removal of the greater omentum. A sample of the resected tissue revealed that it came from fibrovascular connective tissue, which was consistent with the greater omental tissue whose circulation was disturbed. We report here a rare case of a localized defect of the abdominal wall.
