Intestinal Obstruction Due to a Persistent Vitelline Artery<sup>1</sup>

Myers, N. A.; Rubin, S. Z.

doi:10.1111/j.1445-2197.1973.tb07331.x

Cited by 3 publications

(1 citation statement)

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“…10,15 On very rare occasions, OM vessels have persisted intraabdominally as dense fibrous cords causing intestinal obstruction. 6,[16][17][18][19][20] It is normally possible to distinguish persistent OM arteries from persistent OM veins, both of which insert at the peritoneal surface at the base of the umbilicus, based on whether they arise from the small bowel mesentery or the portal vein region, respectively. Blackburn and Cooley have nicely reviewed some of this literature and have provided useful drawings.…”

Section: Discussionmentioning

confidence: 99%

Prevalence, Morphology, Embryogenesis, and Diagnostic Utility of Umbilical Cord Vitelline Vascular Remnants

Wright

2018

Pediatr Dev Pathol

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The objective of this study is to better understand embryonic vitelline vascular remnants in the umbilical cord, to assess their prevalence, to categorize their morphology, and then finally to describe and assess inflammation arising from these structures. During routine placental sign out, the author noted the presence or absence of vitelline vessel remnants for 1 year; when present, he assessed their histologic patterns and noted whether there were neutrophils marginating from the remnants and into the adjacent Wharton's jelly and whether there was any other evidence of amniotic fluid infection in sections of placental disc, membranes, or cord. All cord sections with vitelline vessel remnants were immunostained for CD15 to document any infiltrates, to highlight patterns of infiltration, and to evaluate whether mild cases of umbilical phlebitis were associated with these lesions and were at risk of being missed. Vitelline vessel remnants were present in 4.2% of placentas examined. There were 5 vitelline vessel remnant histologic patterns identified providing insight into the vitelline vessel circulation. Funisitis, primarily neutrophilic, arising from vitelline vessel remnants was present in 70.3% of the 37 cords with vitelline vessel remnants. The presence of vitelline vessel remnant funisitis documents continued active circulation in these vascular structures, and vitelline vessel remnant funisitis was associated with the presence of other placental histological evidence of amniotic fluid infection in 53.8% of cases. The author also reviews normal embryology and the pathology of vitelline vessel remnants.

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Section: Discussionmentioning

confidence: 99%

Prevalence, Morphology, Embryogenesis, and Diagnostic Utility of Umbilical Cord Vitelline Vascular Remnants

Wright

2018

Pediatr Dev Pathol

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Type II single umbilical artery (persistent vitelline artery) in an otherwise normal fetus

et al. 2002

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A single umbilical artery resulting from absence of the umbilical arteries and persistence of the vitelline artery that arises directly from the abdominal aorta has been described only in malformed fetuses with sirenomelia or caudal regression. Such an aberrant artery was suggested to be the etiology of sirenomelia caused by a 'steal' mechanism of blood flow from the caudal end of the embryo. We present a case in which prenatal ultrasound showed a similar aberrant single artery arising from the abdominal aorta in an otherwise normal fetus with a normal course of pregnancy. This vessel, a continuation of the superior mesenteric artery (SMA), corresponds to a persistent vitelline artery assuming the function of the umbilical arteries. The etiology of such a finding and its possible consequences are discussed.

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Laparoscopic Management of Persistent Vitelline Artery Causing Intestinal Volvulus and Obstruction in a Child

Mammadov¹,

Mocan²

2017

Cyprus J Med Sci

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Dear Editor, Persistent omphalomesenteric (vitelline) artery causing intestinal obstruction is an extremely rare congenital condition in pediatric surgery, with only a few case reports in the literature (1-3). Here we present a case that was successfully managed using a laparoscopic approach.A 15-year-old girl presented to our Emergency Department with the complaint of sudden-onset colicky abdominal pain and bilious vomiting. The physical examination revealed tenderness and muscle guarding in the right lower quadrant. Abdominal X-ray showed dilated intestinal segments in the same area, and ultrasonography showed the same findings with free fluid in the right lower quadrant and normal appendix. We preliminarily diagnosed the condition as congenital obstructive fibrotic band compression. Emergent laparoscopic exploration was performed. A standard three-port technique was employed. During exploration, volvulated ileal loops were around an artery-like structure, which originated from the ileocecal mesentery and ended at the anterior abdominal wall, was observed by following the trace of the medial umbilical ligament (Figure 1). Volvulated loops were edematous and seemed to be obstructed. Laparoscopic devolvulation with excision of the artery and elective appendectomy was performed (Figure 2). Pathological evaluation proved the excised structure to be of arterial origin. The patient was uneventfully discharged one day after the surgery.Persistent vitelline artery is one of the omphalomesenteric remnants, which may lead to bowel obstruction and volvulus depending on its configuration (4). The diagnosis of this condition is extremely problematic and mostly depends on the clinician's suspicion. Laparoscopic management seems to be a good option in such rare pediatric conditions.

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Intestinal Obstruction Due to a Persistent Vitelline Artery¹

Abstract: A case of iiitcstinal obstruction rcsitltiiig f r o m a pcrsistetzt vitelline artery is reported. The rarity of tlac condition i s enzphasiccd, and attention is drawn to the dangers of failure to diferentiate betweeiz abdominal pain of emotional and of organic origin.

Cited by 3 publications

References 1 publication

Prevalence, Morphology, Embryogenesis, and Diagnostic Utility of Umbilical Cord Vitelline Vascular Remnants

Prevalence, Morphology, Embryogenesis, and Diagnostic Utility of Umbilical Cord Vitelline Vascular Remnants

Type II single umbilical artery (persistent vitelline artery) in an otherwise normal fetus

Laparoscopic Management of Persistent Vitelline Artery Causing Intestinal Volvulus and Obstruction in a Child

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Intestinal Obstruction Due to a Persistent Vitelline Artery1

Abstract: A case of iiitcstinal obstruction rcsitltiiig f r o m a pcrsistetzt vitelline artery is reported. The rarity of tlac condition i s enzphasiccd, and attention is drawn to the dangers of failure to diferentiate betweeiz abdominal pain of emotional and of organic origin.

Cited by 3 publications

References 1 publication

Prevalence, Morphology, Embryogenesis, and Diagnostic Utility of Umbilical Cord Vitelline Vascular Remnants

Prevalence, Morphology, Embryogenesis, and Diagnostic Utility of Umbilical Cord Vitelline Vascular Remnants

Type II single umbilical artery (persistent vitelline artery) in an otherwise normal fetus

Laparoscopic Management of Persistent Vitelline Artery Causing Intestinal Volvulus and Obstruction in a Child

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Intestinal Obstruction Due to a Persistent Vitelline Artery¹