Persistent Vitellointestinal Duct Causing Bowel Obstruction in an Adult Treated by Laparoscopic Assisted Surgery

Aims: A persistent vitellointestinal duct is a rare finding, typically occurring in the pediatric population. Most commonly presenting as Meckel’s diverticulum, it is extremely rare for it to present as intestinal obstruction in the adult population.

Presentation: The present case report describes a 20 years old male presenting with features of small bowel obstruction due to obliterated fibrous remnant of the duct extending from the umbilicus to the terminal part of the ileum. Early resuscitation and timely intervention ensured that the patient was managed by laparoscopic assisted resection of the vitellointestinal duct and involved ileal segment followed by quick recovery.

Discussion: Intestinal Obstruction due to persistent vitellointestinal duct is an uncommon and very challenging preoperative diagnosis. While in few such case reports they have been managed by laparotomy and sometimes requiring resection of gangrenous small bowel, very rarely it has been treated laparoscopically. The clinical presentation and investigation justified early diagnostic laparoscopy in our patient which enabled a laparoscopic assisted bowel resection with lower morbidity, decreased hospital stay and early return to work.

Conclusion: Diagnosis and management of intestinal obstruction in an adult without history of previous surgery can be challenging. Surgeons must be aware of this uncommon cause of small bowel obstruction to ensure prompt management and better patient outcome.