Systematic review of mesodiverticular band: a rare cause of small bowel strangulation and hemoperitoneum in adults
Sahand Bamarni, SuySen HungFong, Jeffrey Mino, Subhasis Misra
Abstract
Introduction: Mesodiverticular band (MDB) is a rare congenital intestinal malformation. It originates from the embryonic remnant of the vitelline artery and is usually associated with Meckel’s diverticulum (MD). Persistent MDB may cause small bowel obstruction by trapping a loop of bowel, hemoperitoneum due to aneurysmal or traumatic rupture of MDB. The purpose of this article is to review the literature of MDB and identify the patterns of presentation, complications, and management options. Methods: We searched PubMed for articles containing terms: “Mesodiverticular band,” “Vitelline band,” and “Vitelline artery remnant.” Abstracts were reviewed in detail and we included all the case reports available in full-text and in English language. We excluded all case reports of patients younger than 18 years of age. Results: Only 20 case reports were included. Only adult patients were included. The male to female ratio was 3:1. The most common presentation was small bowel obstruction followed by hemoperitoneum. The majority required exploratory laparotomy with more than half requiring small bowel resection. One death report secondary to undiagnosed internal hernia. Conclusion: MDB with MD is a rare cause of intestinal obstruction or hemoperitoneum in adults. It remains a diagnostic dilemma as it is usually diagnosed intraoperatively.