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Naous A, Itani R, Itani MK, Naja Z, Rajab M. Congenital adhesion band: A rare case in a neonate. Radiol Case Rep 2024; 19:499-502. [PMID: 38044906 PMCID: PMC10686888 DOI: 10.1016/j.radcr.2023.10.076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 10/26/2023] [Accepted: 10/29/2023] [Indexed: 12/05/2023] Open
Abstract
Diseases of the gastrointestinal system may be congenital or acquired. Intestinal obstruction is common in children and neonates, and it has various causes. Obstructions due to congenital adhesion bands are rare. Few cases were reported in the literature. In this paper, we will discuss the case of an 8-day-old girl who was presented to the emergency department with signs of intestinal obstruction.
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Affiliation(s)
- Amal Naous
- Faculty of Medicine and Surgery, Beirut Arab University, Beirut, Lebanon
- Department of Pediatrics, Makassed General Hospital, Beirut, Lebanon
| | - Rania Itani
- Faculty of Medicine and Surgery, Beirut Arab University, Beirut, Lebanon
| | | | - Zeina Naja
- Department of Pediatrics, Makassed General Hospital, Beirut, Lebanon
| | - Mariam Rajab
- Department of Pediatrics, Makassed General Hospital, Beirut, Lebanon
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2
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Maree G, Alelayan A, Hemi F, Shater W, Ghuzlan A, Ali W. Jejunal obstruction due to jejunocolic congenital band in a 12-year-old child: a case report. J Med Case Rep 2022; 16:433. [DOI: 10.1186/s13256-022-03546-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 07/25/2022] [Indexed: 11/11/2022] Open
Abstract
Abstract
Background
A congenital band is an uncommon abnormality that can be found anywhere along the gastrointestinal tract. Intestinal obstruction caused by an anomalous congenital band is very rare in children. To the best of our knowledge, no cases of congenital bands extending from the descending colon to the jejunum have been reported in the English literature
Case presentation
Herein, we present the case of a 12-year-old Syrian patient with intestinal obstruction due to a congenital band extending from the mesentery of the descending colon to the mesentery of the jejunum with an entrapped loop of jejunum between the band and the mesentery. The location of the obstruction was determined by upper gastrointestinal contrast radiography, but the cause of the obstruction was diagnosed intraoperatively. The band was excised without intestinal resection.
Conclusion
Prediagnosis of congenital bands can be challenging, and surgery is required. When making a bowel obstruction differential diagnosis, it is important to keep this type of band in mind.
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Chronic descending colon obstruction caused by congenital band. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2022. [DOI: 10.1016/j.epsc.2022.102290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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4
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Weledji EP, Monono N. Congenital adhesion bands causing distal duodenal obstruction in a 6-year old child. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2021. [DOI: 10.1016/j.epsc.2021.101966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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5
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Cruise DA, Goddard K. Congenital band adhesion causing a proximal jejunal obstruction: an uncommon presentation and diagnosis. BMJ Case Rep 2019; 12:12/7/e229235. [PMID: 31352380 DOI: 10.1136/bcr-2019-229235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
A 20-year-old woman with no medical or surgical history presented with acute onset crampy abdominal pain on a background of uninvestigated similar chronic abdominal pain. She became obstructed during her admission and a contrast swallow showed a complete obstruction at the level of the proximal jejunum. A diagnostic laparoscopy revealed a congenital band adhesion from the greater omentum to the proximal jejunum to be the cause, and dissection of the band relieved her obstruction. This case presents a rare cause of mechanical obstruction, and highlights the seriousness of investigating obstructive symptoms even in atypical patient populations.
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Affiliation(s)
- David Ashley Cruise
- General Surgery, Armadale Health Service, Armadale, Western Australia, Australia
| | - Kim Goddard
- General Surgery, Armadale Health Service, Armadale, Western Australia, Australia
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Safety and Indications of Laparoscopic Surgery for Postoperative Small-bowel Obstruction: A Single-center Study of 121 Patients. Surg Laparosc Endosc Percutan Tech 2018; 27:301-305. [PMID: 28614173 DOI: 10.1097/sle.0000000000000430] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND/AIMS The purpose of this study was to evaluate the safety and effectiveness of laparoscopic surgery for the treatment of small-bowel obstruction. MATERIALS AND METHODS The study group comprised 121 patients who underwent laparoscopic surgery for small-bowel obstruction. RESULTS Previous operations were open surgery in 107 patients and laparoscopic surgery in 14. On univariate analysis, 4 risk factors were related to conversion to open surgery: radiotherapy (P=0.0002), previous episode of intestinal obstruction (P=0.0064), bleeding volume of ≥50 mL (P=0.0059), and the presence or absence of previous bowel resection (P=0.0269). On multivariate analysis, only radiotherapy was an independent risk factor for conversion to open surgery (odds ratio, 5.5141; P=0.0091). CONCLUSIONS Laparoscopic surgery can be safely performed in patients with postoperative small-bowel obstruction and is considered an effective treatment with a low rate of recurrent bowel obstruction.
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Yang KH, Lee TB, Lee SH, Kim SH, Cho YH, Kim HY. Congenital adhesion band causing small bowel obstruction: What's the difference in various age groups, pediatric and adult patients? BMC Surg 2016; 16:79. [PMID: 27927245 PMCID: PMC5142405 DOI: 10.1186/s12893-016-0196-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Accepted: 11/30/2016] [Indexed: 11/14/2022] Open
Abstract
Background A congenital adhesion band is a rare condition, but may induce a small bowel obstruction (SBO) at any age. However, only a few sporadic case reports exit. We aimed to identify the clinical characteristics of congenital adhesion band manifesting a SBO stratified by age group between pediatric and adult patients. Methods The medical records of all patients with a SBO between Jan 1, 2009 and Dec 31, 2015 were retrospectively reviewed. Cases associated with previous surgical procedure and cases of secondary obstruction due to inflammatory processes or tumor and other systemic diseases were excluded. The patients were divided into two groups according to age below or above 18 years: pediatric and adult. The basic clinical characteristics were analyzed and compared between groups. Results Of 251 patients with a SBO, 15 (5.9%) met the inclusion criteria; 10 cases in pediatric group (mean age 17.9 ± 38.7 months) and 5 cases in adult group (mean age 60.0 ± 19.7 years). The pediatric group (66.6%) included 3 neonates, 5 infants, and 2 school children. They usually presented with bilious vomiting (50.0%) and abdominal distention (60.0%), and demonstrated a high rate of early operation (80.0%) and bowel resection (70.0%). In contrast, the adult group (33.3%) presented with abdominal pain (100%) in all cases and underwent a relatively simple procedure of band release using a laparoscopic approach (60%). However, group differences did not reach statistical significance. In addition, two groups did not differ in the time interval to the operation or in the range of the operation (p = 0.089 vs. p = 0.329). No significant correlation was found between the time interval to the operation and the necessity of bowel resection (p = 0.136). There was no mortality in either group. Conclusions Congenital adhesion band is a very rare condition with diverse clinical presentations across ages. Unlike adult patients, pediatric patients showed a high proportion of early operation and bowel resection. A good result can be expected with an early diagnosis and prompt management regardless of age.
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Affiliation(s)
- Kwang-Ho Yang
- Department of Surgery, Pusan National University Yangsan Hospital, Yangsan, Korea.,Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Tae-Beom Lee
- Department of Surgery, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Si-Hak Lee
- Department of Surgery, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Soo-Hong Kim
- Department of Surgery, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Yong-Hoon Cho
- Department of Surgery, Pusan National University Yangsan Hospital, Yangsan, Korea. .,Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea. .,Department of Surgery, Pusan National University School of Medicine, Geumo-ro 20, Mulgeum-eup, 50612, Yangsan, Gyeongnam, Korea.
| | - Hae-Young Kim
- Department of Surgery, Pusan National University Yangsan Hospital, Yangsan, Korea
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Abdelwahed Y, Saber R, Imen BI, Hakim Z, Ayoub Z. A case report of small bowel obstruction secondary to congenital peritoneal band in adult. Int J Surg Case Rep 2016; 30:23-25. [PMID: 27898351 PMCID: PMC5128824 DOI: 10.1016/j.ijscr.2016.11.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Revised: 11/06/2016] [Accepted: 11/06/2016] [Indexed: 11/18/2022] Open
Abstract
A case of small bowel obstruction due to peritoneal congenital band is presented. Computed tomography is effective for diagnosis. The laparoscopic approach for surgical treatment should be intended initially for its feasibility and benefits. A quick management is necessary to avoid intestinal necrosis.
Introduction Small bowel obstruction (SBO) is common in adult surgical procedures, mainly due to postoperative adhesions. Acute SBO in adults without history of abdominal surgery, trauma or clinical hernia is less common and has various etiologies. Congenital band is an extremely rare cause. Presentation of case A 56-year-old man was admitted to our hospital with a two-day history of abdominal pain and bilious vomiting. He had no history of abdominal surgery or any other medical problems. A contrast-enhanced CT of the abdomen showed a distention of small bowel loops with transition point in the right hypochondrium. Distended loops of small bowel were located in the left side of the abdomen, whereas collapsed loops was located in the right side. The normal bowel wall enhancement was preserved. After initial treatment with intravenous fluid and nasogastric suction, he was operated. At laparoscopy a band obstructing the ileum was clearly observed. This anomalous band extending from gallbladder to transverse mesocolon caused a small window leading to internal herniation of the small bowel and obstruction. The band was coagulated and divided. Postoperative outcome was uneventful and the patient was discharged on the second postoperative day. There was no recurrence of symptoms on subsequent follow-up. Discussion Congenital peritoneal bands are not frequently encountered in surgical practice and these bands are often difficult to classify and define. Diagnosis of acute intestinal obstruction due to CPB must be included in the differential diagnosis in any patient with no history of abdominal surgery, trauma, clinical hernia, inflammatory bowel disease or peritoneal tuberculosis. Conclusion Despite technological advances in radiology preoperative diagnosis remains difficult, however the diagnosis of SBO due to CPB must be considered in any patient with no history of abdominal surgery, Trauma or clinical hernia consulting for occlusive syndrome. The laparoscopic approach should be intended initially for its feasibility and benefits.
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Affiliation(s)
- Yahmadi Abdelwahed
- Department of General Surgery, Trauma and Burns Center, Ben Arous, Tunisia.
| | - Rebii Saber
- Department of General Surgery, Trauma and Burns Center, Ben Arous, Tunisia
| | - Ben Ismail Imen
- Department of General Surgery, Trauma and Burns Center, Ben Arous, Tunisia
| | - Zenaidi Hakim
- Department of General Surgery, Trauma and Burns Center, Ben Arous, Tunisia
| | - Zoghlami Ayoub
- Department of General Surgery, Trauma and Burns Center, Ben Arous, Tunisia
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9
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Laparoscopic Surgery is Useful for Preventing Recurrence of Small Bowel Obstruction After Surgery for Postoperative Small Bowel Obstruction. Surg Laparosc Endosc Percutan Tech 2016; 26:e1-4. [PMID: 26771166 PMCID: PMC4736302 DOI: 10.1097/sle.0000000000000238] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Risk factors for recurrence postoperative small bowel obstruction in patients who have postoperative abdominal surgery remain unclear. MATERIALS AND METHODS The study group comprised 123 patients who underwent surgery for ileus that developed after abdominal surgery from 1999 through 2013. There were 58 men (47%) and 65 women (53%), with a mean age of 63 years (range, 17 to 92 y). The following surgical procedures were performed: lower gastrointestinal surgery in 47 patients (39%), gynecologic surgery in 39 (32%), upper gastrointestinal surgery in 15 (12%), appendectomy in 9 (7%), cholecystectomy in 5 (4%), urologic surgery in 5 (4%), and repair of injuries caused by traffic accidents in 3 (2%). Laparoscopic surgery was performed in 75 patients (61%), and open surgery was done in 48 (39%). We examined the following 11 potential risk factors for recurrence of small bowel obstruction after surgery for ileus: sex, age, body mass index, the number of episodes of ileus, the number of previously performed operations, the presence or absence of radiotherapy, the previously used surgical technique, the current surgical technique (laparoscopic surgery, open surgery), operation time, bleeding volume, and the presence or absence of enterectomy. RESULTS The median follow-up was 57 months (range, 7 to 185 mo). Laparoscopic surgery was switched to open surgery in 11 patients (18%). The reason for surgery for postoperative small bowel obstruction was adhesion to the midline incision in 36 patients (29%), band formation in 30 (24%), intrapelvic adhesion in 23 (19%), internal hernia in 13 (11%), small bowel adhesion in 20 (16%), and others in 1 (1%). Postoperative complications developed in 35 patients (28%): wound infection in 12 (10%), recurrence of postoperative small bowel obstruction in 12 (10%), paralytic ileus in 4 (3%), intra-abdominal abscess in 3 (2%), suture failure in 1 (1%), anastomotic bleeding in 1 (1%), enteritis in 1 (1%), and dysuria in 1 (1%). Enterectomy was performed in 42 patients (38%). On univariate analysis, 2 risk factors were significantly related to the recurrence of small bowel obstruction: open surgery (P=0.017) and bleeding volume (P=0.031). On multivariate analysis, open surgery was an independent risk factor for the recurrence of small bowel obstruction (odds ratio, 5.621; P=0.015). CONCLUSIONS Open surgery was an independent risk factor for the recurrence of small bowel obstruction after abdominal surgery. In the future, laparoscopic surgery should be performed to prevent the recurrence of small bowel obstruction.
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Nicolas G, Kfoury T, Shimlati R, Koury E, Tohmeh M, Gharios E, Wakim R. Diagnosis and Treatment of Small Bowel Strangulation Due To Congenital Band: Three Cases of Congenital Band in Adults Lacking a History of Trauma or Surgery. AMERICAN JOURNAL OF CASE REPORTS 2016; 17:712-719. [PMID: 27713389 PMCID: PMC5058432 DOI: 10.12659/ajcr.899664] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Among the causes of constipation are bands and adhesions that lead to obstructions at different points in the intestinal tract. These can occur as a consequence of healing following surgery or trauma. However, an entity known as congenital band exists where a band is present from birth. Here we report three such cases of adults with symptoms of intestinal obstruction, in whom a congenital band was discovered through exploratory laparoscopy. CASE REPORT All three of these patients presented lacking a history of any abdominal trauma or previous abdominal surgeries, a fact that is often used to exclude an adhesion as a differential. All three recovered quickly and had relief of their symptoms following surgical intervention. CONCLUSIONS Bands and adhesions are common surgical causes of small bowel obstruction, leading to symptoms such as nausea, vomiting, constipation, and obstipation. These bands almost always result from a prior abdominal surgery or from a recent abdominal trauma. The three cases presented here show a far more unusual picture of a band, one that is congenitally present, as there was an absence of such a history. This is significant because clinical suspicion of a band is often very low due to a lack of distinguishing clinical and diagnostic features, and when the past history is negative.
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Affiliation(s)
- Gregory Nicolas
- Department of Surgery, Mount Lebanon Hospital, Lebanese American University, Beirut, Lebanon
| | - Tony Kfoury
- Department of Surgery, Mount Lebanon Hospital, Lebanese American University, Beirut, Lebanon
| | - Rasha Shimlati
- Department of Surgery, Mount Lebanon Hospital, Lebanese American University, Beirut, Lebanon
| | - Elliott Koury
- Department of Surgery, Mount Lebanon Hospital, Lebanese American University, Beirut, Lebanon
| | - Maroon Tohmeh
- Department of Surgery, Mount Lebanon Hospital, Lebanese American University, Beirut, Lebanon
| | - Elie Gharios
- Department of Surgery, Mount Lebanon Hospital, Lebanese American University, Beirut, Lebanon
| | - Raja Wakim
- Department of Surgery, Mount Lebanon Hospital, Lebanese American University, Beirut, Lebanon
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11
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[Congenital anomaly band, a rare cause of intestinal obstruction in children. Case report]. CIR CIR 2016; 85:164-167. [PMID: 26769532 DOI: 10.1016/j.circir.2015.10.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2015] [Accepted: 10/16/2015] [Indexed: 11/23/2022]
Abstract
BACKGROUND Intestinal obstruction in children may be congenital, acquired, intrinsic or extrinsic. Most intestinal obstructions in children are the result of postoperative adhesions. Those caused by anomalous congenital band are extremely rare. CLINICAL CASE Patient of a 1-year-old male, with no previous history of abdominal surgery or trauma. He suffered with vomiting of bile content and loss of appetite at home three days before admission. On physical examination, he was irritable, with abdominal distention, absence of peristalsis and abdominal tenderness, with no signs of peritoneal irritation being found. The blood count reported leucocytosis and the x-rays show dilated small bowel loops, fluid levels and absence of air in rectal ampulla. An open laparotomy was subsequently performed, and the intraoperative findings were consistent with a congenital band extending from the anti-mesenteric wall of the jejunum to the root of mesentery, compressing the ileum at 50cm from the ileocecal valve, causing ischaemia. The band was ligated and divided, with an uneventful postoperative course. He was discharged 4 days later without complications. CONCLUSIONS The anomalous congenital band is not associated with abdominal problems, such as remnants of previous laparotomies or embryological structures, such as vitelline vessels or omphalomesenteric yolk duct. These bands seem to have a congenital origin and cause bowel obstruction by trapping between the band and the mesentery. The diagnosis of anomalous congenital band is extremely difficult and no imaging study is useful for the diagnosis, and only exploratory laparotomy or laparoscopy is useful for diagnosis and treatment of this problem.
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12
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Congenital membrane causing duodenal obstruction and malpositioning of the descending colon. Pediatr Neonatol 2013; 54:275-7. [PMID: 23597513 DOI: 10.1016/j.pedneo.2012.10.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2012] [Revised: 05/01/2012] [Accepted: 06/25/2012] [Indexed: 10/27/2022] Open
Abstract
A congenital membrane without intestinal malrotation is a rare cause of duodenal obstruction. Here we present an 11-year-old girl who had suffered from intermittent abdominal cramping pain and vomiting for more than 5 years. The image studies, including a plain abdomen roentgenogram and sonogram, showed no definite diagnosis. The upper gastrointestinal series and small bowel series showed the contrast was static over the third portion of the duodenum and the descending colon pulled up toward the epigastric area. Laparoscopic exploration revealed a congenital membrane extending from the right-side paraduodenal peritoneum through the third portion of the duodenum to the descending colon, which had caused obstruction of the third portion of the duodenum and malpositioning of the descending colon. To the best of our knowledge, this is the first case report in the literature where a congenital membrane caused both duodenal obstruction and malpositioning of the descending colon.
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13
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Chang YT, Chen BH, Shih HH, Hsin YM, Chiou CS. Laparoscopy in children with acute intestinal obstruction by aberrant congenital bands. Surg Laparosc Endosc Percutan Tech 2011; 20:e34-7. [PMID: 20173608 DOI: 10.1097/sle.0b013e3181cdb89a] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Aberrant congenital bands are a rare cause of acute intestinal obstruction and usually present a diagnostic challenge. In 2008, the authors encountered 2 children with acute terminal ileal herniation. In the first case, it was caused by a mesodiverticular band, and numerous freely hanging filmy membranes attached to the antimesenteric side of the small intestine were found concurrently; whereas, an anomalous band from the distal ileum to the cecum was the leading cause in the second case. The vascularity of both herniated intestines was not compromised, and laparoscopy was successfully carried out 84 and 93 hours after the onset of the symptoms, respectively. Instead of cohesive adhesions, both of the causes related to a single vascular band, and laparoscopy was an effective and safe tool in diagnosis and subsequent treatment. The case with a mesodiverticular band and filmy membranes is the first case report with incomplete regression of both the vitelline circulation and the ventral mesentery.
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Affiliation(s)
- Yu-Tang Chang
- Division of Pediatric Surgery, Department of Surgery, Kaohsiung Municipal Hsiao-Kang Hospital, Faculty of Medicine, College of Medicine, Graduate Institute of Medicine, Kaohsiung, Taiwan.
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14
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Fang AC, Carnell J, Stein JC. Constipation in a 7-year-old boy: congenital band causing a strangulated small bowel and pulseless electrical activity. J Emerg Med 2010; 42:283-7. [PMID: 20832966 DOI: 10.1016/j.jemermed.2010.05.092] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2009] [Revised: 03/30/2010] [Accepted: 05/28/2010] [Indexed: 11/18/2022]
Abstract
BACKGROUND Constipation in pediatric patients is a common diagnosis in the emergency department (ED) and may occasionally arise from a significant underlying illness. OBJECTIVE To discuss a rare cause of constipation that led to a strangulated small bowel and cardiac arrest. CASE REPORT A 7-year-old boy presented in pulseless electrical activity. The patient had been seen in the ED 2 days prior with the complaint of abdominal pain, which was diagnosed as constipation. The boy had emigrated from Mexico 18 months earlier. The patient was resuscitated in the ED and taken emergently to the operating room. During surgery he was discovered to have a congenital abdominal adhesive band that led to a strangulated small bowel. He suffered subsequent multi-organ failure, including hypoxic ischemic encephalopathy, and was hospitalized for 5 months. One month after discharge he was improving and being followed by multiple providers. CONCLUSION Congenital adhesive bands, although rare, may be life-threatening anomalies. We present this case to increase awareness of this condition among emergency physicians.
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Affiliation(s)
- Andrea C Fang
- Department of Emergency Medicine, University of California, San Francisco, San Francisco, California 94143, USA
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15
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Kumar A, Ramakrishnan TS, Sahu S. Large Bowel Obstruction by Anomalous Congenital Band. Med J Armed Forces India 2009; 65:378-9. [PMID: 27408298 PMCID: PMC4921359 DOI: 10.1016/s0377-1237(09)80110-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2009] [Accepted: 07/07/2009] [Indexed: 02/07/2023] Open
Affiliation(s)
- A Kumar
- Graded Specialist (Surgery), 7 Air Force Hospital, Kanpur
| | - TS Ramakrishnan
- Senior Advisor (Surgery and Orthopaedics), 7 Air Force Hospital, Kanpur
| | - S Sahu
- Graded Specialist (Radiology), Institute of Aerospace Medicine, Vimanpura, Bangalore
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16
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Adhesional Small Bowel Obstruction in the Absence of Previous Operations: Management and Outcomes. World J Surg 2009; 33:2368-71. [DOI: 10.1007/s00268-009-0200-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Dimitrios C, George AA, Dimosthenis Z, Nikolaos X. Intestinal obstruction due to an anomalous congenital band. Saudi J Gastroenterol 2008; 14:36-7. [PMID: 19568494 PMCID: PMC2702889 DOI: 10.4103/1319-3767.37806] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2007] [Accepted: 11/15/2007] [Indexed: 11/04/2022] Open
Abstract
We report a case of a 20-year-old male who presented with symptoms and signs of intestinal obstruction. The patient reported no previous history of abdominal surgery or trauma while clinical and radiographic examinations were not diagnostic. An open laparotomy was subsequently performed and the intraoperative findings were consistent with a congenital band extending from the antimesenteric wall of the jejunum to the root of mesentery. The band was ligated and divided with an uneventful postoperative course. Congenital bands are extremely rare. Their exact incidence is still unknown and usually observed in childhood. This case, therefore, represents an unusual surgical problem in an older individual in which the diagnosis was clinically unexpected.
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Affiliation(s)
| | - Alexiou A. George
- Department of Surgery, University Hospital of Ioannina, Greece,Address: Dr. Alexiou George, P.O. Box 103, Neohoropoulo, Ioannina, 455 00, Greece. E-mail:
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18
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Palanivelu C, Rangarajan M, Maheshkumaar GS, Rajan PS. Relaparoscopy in the management of acute abdomen due to localized ischemic bowel: a novel technique--case report. Int J Surg 2007; 6:e89-91. [PMID: 17561464 DOI: 10.1016/j.ijsu.2007.04.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2007] [Accepted: 04/13/2007] [Indexed: 11/29/2022]
Abstract
Diagnostic and therapeutic laparoscopy for acute abdomen has been widely reported in the literature. Diagnostic laparoscopy has an accuracy of 99.08% and 1% morbidity. The usefulness of relaparoscopy in acute abdomen has also been reported. We describe a patient with acute abdominal pain who underwent diagnostic laparoscopy. Ischemic segment of small bowel was found and it was decided not to resect but to go in for a second look 48h later. Relaparoscopy revealed the ischemic segment to regain vascularity, so nothing further was done. The patient recovered well and was discharged on the 6th postoperative day. Laparotomy was avoided both the times, thus sparing the patient of morbidity and prolonged hospital stay. Other advantages are lower risk of incisional hernias, less postoperative pain and early return to normal activity. Laparoscopy and relaparoscopy certainly has a definite role in the management of acute abdomen, at least diagnostic if not therapeutic.
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Affiliation(s)
- Chinnusamy Palanivelu
- GEM Hospital, Surgical Gastroenterology & MAS, 45-A, Pankaja Mill Road, Ramanathapuram, Coimbatore 641045, India
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