Laparoscopic Management of Intestinal Obstruction in a Young Adult with a Virgin Abdomen: Unusual Presentation of Combined Vitellointestinal Duct Remnants: A Clinical Case Report

Key Clinical Message: In an 18-year-old, Meckel's diverticulum and a rare vitellointestinal fibrous band caused bowel obstruction. Clinicians should be vigilant for such anomalies, especially in young adults with virgin abdomens, as potential sources of intestinal obstruction.

Abstract: In this case report, we highlight the rarity of vitellointestinal or omphalomesenteric duct anomalies causing intestinal obstruction in the adult population. The patient, an 18-year-old male, presented to the emergency department with a two-day history of abdominal pain and vomiting. Physical examination revealed mild distension of his virgin abdomen with generalized tenderness. Abdominal X-ray displayed dilated small bowel loops, and a computed tomography scan indicated features consistent with closed-loop bowel obstruction. Diagnostic laparoscopy confirmed a vitellointestinal duct remnant as the cause of the small intestinal obstruction, involving a combined Meckel's diverticulum and vitellointestinal fibrous band. In early fetal development, the vitellointestinal duct communicates between the midgut and the yolk sac, expected to disappear during fetal growth. Failure to obliterate can lead to issues such as intestinal blockage, primarily observed in children, making occurrences in adults, as in this case, infrequent with only a few documented instances. Despite its uncommon occurrence in young adults, healthcare providers should consider the vitellointestinal duct anomalous remnant as a potential source of intestinal obstruction, particularly in individuals with a virgin abdomen. Early detection of intestinal obstruction is imperative for patient survival, facilitating prompt management and minimizing the risk of serious morbidities, ultimately contributing to a better patient outcome.