Small intestinal obstruction by remnants of the omphalomesenteric duct: findings on contrast enema

Objective. We reviewed the contrast enema examinations and medical records of six patients with small intestinal obstruction due to omphalomesenteric duct remnant to evaluate for characteristic imaging findings. Results. In five out of the six patients the point of obstruction was demon strated on the enema; in three patients, the characteristic "beak" of a vol vulus was seen, either in the terminal ileum or cecum. In three patients, t here was medial deviation of the cecum. Conclusion. The characteristic radiographic features of volvulus at the cec um or terminal ileum and medial deviation of the cecum should suggest persi stence of an omphalomesenteric duct remnant as the etiology of obstruction in a child less than 2 years of age. The appearance of omphalomesenteric du ct remnant obstruction on enema examination, though not specific, is charac teristic and should be familiar to pediatric radiologists.