Vittelointestinal duct remnant

Published: 05/18/2012

Authors: Roberts JK, Premartne S, Gilmour J and Lam FT

Ischaemic loops of small bowel, without clear cause, were seen at laparoscopy done for peritonism in a 20 year old. Upon converting to lower midline laparotomy the registrar found himself entering small bowel adherent to the umbilicus. The distal small bowel had undergone volvulus around a Meckels diverticulum, patent throughout its length, extending to the umbilicus (Fig. 1: pre-peritoneal fat can be seen at the Meckel’s tip). Vittelointestinal duct remnants must be kept in mind when performing laparoscopy, as umbilical attachments will not be seen with conventional umbilical port placement and are at risk when entering the peritoneum.