Cumhuriyet Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi

Yazarlar: Umut ALICI, Baran TOKAR

Konular:Tıp

Anahtar Kelimeler:Medial umbilical ligament,Abdominal pain,Nonpalpable testis,Laparoscopy,Abdominal wall,Child

Özet: Obliterated umbilical arteries called as medial umbilical ligament (MUL) located in umbilicovesical fascia. In English literature, pathologies associated with anatomical variations of MUL have not been described. We present a 7-year-old male patient admitted with chronic colic lower abdominal pain and left non-palpable testis. Laparoscopic exploration showed a significant stretched fibrous cord like MUL with a peritoneal web on the both sides. The both ligaments were totally excised. Orchidopexy was performed for the left intraabdominal testis. The patient was pain free in the second year of follow up. Since there is a cross-neural sensitization among pelvic structures, a significantly tense MUL might be considered as a pathology causing recurrent abdominal pain by stretching and innervating the sensory neural fibers. Laparoscopy easily exposes if there is a stretching web like MUL from umbilicus to the pelvis. During an exploration for chronic abdominal pain with unknown etiology, if a significant pathology could not be identified, pain related to a tense fibrous MUL might be considered in the differential diagnosis.   

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