Laparoscopic Treatment of a Small Bowel Volvulus Secondary to an Uncommon Omphalomesenteric Remnant

Introduction: Intestinal obstruction is a well-known complication in the presence of various types of omphalomesenteric duct remnants. The omphalomesenteric duct is an embryologic communication between the yolk sac and the primitive midgut. Failure of complete reabsorption results in a variety of anomalies, like an omphalomesenteric fistula, a sinus tract or cyst, fibrous connection of the ileum to the umbilicus, or most frequently, a Meckel’s diverticulum. These conditions can remain asymptomatic or present with several complication. Intestinal obstruction is the second most common complication and typically results secondary to twisting of the small bowel around a remnant band. Anomalies derived from the vitelline vascular system are rarely encountered, but may be associated with poor outcom. Laparoscopic surgery currently represents a reliable resource for the diagnosis and treatment of these cases. Case presentation: We report a case of a 9-year-old boy who presented a small intestine volvulus secondary to an uncommon lipovascular cord, compatibile with a vitelline artery remnant. Laparoscopic diagnosis and treatment were succesfully performed. Discussion: Isolated vitelline vascular remnants are rarely encountered, but their careful management is essential. With this case, we highlight the reliability of the laparoscopic approach for both diagnosis and treatment of these rare causes of intestinal obstruction.