Small intestinal obstruction is the most commonly found surgical problem of the small intestine. Generally patients with small bowel obstruction present with variable clinical symptoms and sign such as pain in abdomen , vomiting, constipation, abdominal distension and tenderness [4,7]. Intraabdominal adhesions associated to previous abdominal surgery is the commonest cause of mechanical small bowel obstruction. Other causes are hernias, neoplasms, malrotation , tuberculosis and inflammatory bowel diseases. Conversely, in patients without abdominal surgery history, it is tough to diagnose and manage.
Early and exact diagnosis of intestinal obstruction and its causes are essential and proper treatment is of greatest significance …show more content…
Early and prompt diagnosis is especially main for the hazardous closed loop type obstruction, in which a segment of intestine obstructed both distally and proximally leads to rapid increase in the luminal pressure, and progresses to strangulation.[9,10] Small bowel volvulus is one of the common causes of closed loop obstruction; therefore, early surgery prevented the strangulation of the intestinal loops. Bowel obstruction due to persistent omphalomesenteric duct is a extremely rare disorder in adults with very few reports stated in the …show more content…
It is challenging to know the causes of the intestinal obstruction without diagnostic laparotomy or laparoscopy. Plain X-ray abdomen and ultrasonography are non-specific for small bowel obstruction. Computerized tomography of abdomen may be beneficial to show the band originating from the umbilicus and continuing between the small bowel loops, as described in the literature [6]. In our study , we did not perform computerized tomography, and both the plain radiographs and the abdominal ultrasonography were non-diagnostic. Nevertheless, diagnosis was made during laparotomy. Most of cases surgical excision of the fibrotic band is sufficient therapy. If intestine is gangrenous, intestinal resection should be considered like in our case. Several studies have mentioned different approaches for symptomatic persistent OMD such as open surgical excision or laparoscopic