A Case of Strangulation Ileus Due to Vitelline Vascular Remnants without Meckel’s Diverticulum

A 80-year-old woman visited our hospital with a complaint of abdominal pain and vomiting. Her abdomen showed muscular guarding with tenderness in the right lower quadrant. Abdominal CT showed an area of poor contrast of the small intestine in the right lower abdomen with surrounding ascites. We diagnosed strangulation ileus in the small intestine and performed emergency surgery. In surgery, the cord was found to be continuous from the posterior wall at the umbilicus into the abdominal cavity, and the small intestine was strangulated. The strangulation was released when the cord was resected. The cord was continuous to the anterior of the ileal mesentery about 20 cm proximal from the ileocecal valve. No Meckel’s diverticulum was found. Histopathological examination revealed that the cord contained an artery and vein, and was diagnosed as vitelline vascular remnants. Vitelline vascular remnants without Meckel’s diverticulum are often found in the presence of ileus, making diagnostic imaging and preoperative diagnosis difficult. Prophylactic resection of vitelline vascular remnants may be desirable if a diagnosis can be made or if they are discovered by chance during surgery.