Abstract
A case of strangulating obstruction caused by mesodiverticular vascular band is deseribed. A 3-year-old boy was admitted to the department because of abdominal pain and vomiting. A plain X-ray film of the abdomen showed a fluid level in the dilated intestinal loop and ultrosonic study demonstrated both the some amount of ascites and weakness of intestinal peristalsis around the right lower quadrant of the abdomen.
The patient underwent emergency operation and was found a strangulated intestine with moderate vascular disturbance and both the Meckel's diverticulum and a about 2 cm length band coursing from the tip of the diverticulum to the anterior leaf of mesentery of the terminal ileum about 40 cm proximal from the ileocecal valve. The main reason of the intestinal obstruction was considered that above band compressed the wall of the bowel at 3 cm proximal to the diverticulum, and strangulation occurred by twisting of the mesentery with about 50 cm length of the ileum toward 180 degree to clockwise direction as a volvulus. Then, the diverticulum was removed by wedge resection following reduction of the intestinal obstruction. The histopathological examination revealed that the band contained not only arterial component but also venous one.
The embryological view of the vitelline vein, which has not arrived at any agreement as yet, and a review of 24 cases reported in Japan are presented.
