Ileal atresia secondary to antenatal strangulation of Littre's hernia in an exomphalos minor

Abstract

SUMMARYWe describe an unusual case of ileal atresia, resulting from antenatal strangulation of a Meckel's diverticulum in an exomphalos minor. This is a rare antenatal complication of Littre's hernia, which has not been previously described. A small exomphalos minor at the base of umbilical cord and late onset vascular accident at the narrow defect leading to ileal atresia may be missed in the prenatal diagnosis. The triad of exomphalos minor, Meckel's diverticulum and terminal ileal atresia secondary to antenatal strangulation of Littre's hernia is very rare to find in the same patient. A small exomphalos minor at the base of the umbilical cord can be missed even in the postnatal period. Our case lends direct evidence of vascular accident as a cause of ileal atresia and supports vascular theory. Whenever possible umbilicus should be preserved naturally and exomphalos sac should be opened higher up for excellent cosmetic results. BACKGROUND

Dual Type (Type I, Type IIIa) Ileal Atresia with Minor Omphalocele

“…capable of intestinal and mesenteric compression by the interruption of blood supply resulting in ischemia [4,5]. Pratap et al [6] described a case of ileum entrapped within the omphalic ring and that entrapped segment of ileum was atretic. Patel et al [6] reported an unusual case of ileal atresia resulting from antenatal strangulation of Meckels diverticulum in omphalocele minor.…”

“…Pratap et al [6] described a case of ileum entrapped within the omphalic ring and that entrapped segment of ileum was atretic. Patel et al [6] reported an unusual case of ileal atresia resulting from antenatal strangulation of Meckels diverticulum in omphalocele minor. The first association of ileal atresia with Omphalocele minor is the single isolated type.…”

Importance of the Early Management of Omphalocele Minor

“…Studies have shown that small omphalocele associated with noncardiac anomalies has overall good prognosis [19][20][21] (Figure 2). Patients with small omphalocele have fewer cardiac defects, which may explain their better prognosis as severe cardiac defects portend poorer prognosis.…”