Duodenal Obstruction Due to Two Congenital Bands: a Case Report and Literature Review

Overview

Journal Front Pediatr

Date 2025 Feb 3

PMID 39896722

Authors

Shiqiu Xiong

Kuku Ge

Chongzhi Hou

Hongbin Yang

Hanhua Zhang

Sheng Zhang

Bailing Liu

Yuewen Hao

Ying Fang

Xiaoxia Ren

Affiliations

Soon will be listed here.

Abstract

Introduction: Anomalous congenital bands are a rare cause of intestinal obstruction, with only five previously reported cases involving duodenal obstruction. We present a fifth case of duodenal obstruction due to two congenital bands and provide a comprehensive literature review summarizing the clinical features of this condition.

Case Report: An eight-year-old girl was admitted to our department with recurrent bilious vomiting and abdominal pain lasting six days. She had no significant past medical history, with no previous abdominal surgeries or trauma. Physical examination revealed abdominal tenderness and decreased bowel sounds. Contrast x-ray showed an obstructed passage of contrast through the third part of the duodenum. Abdominal ultrasound identified a strip-like hypoechoic structure compressing the third part of the duodenum. A diagnosis of duodenal obstruction was confirmed, and laparoscopic surgery combined with gastroduodenoscopy was performed. The procedure revealed two congenital bands adjacent to the duodenum: one extending from the duodenum to the transverse colon, and the other from the duodenum to the root of the mesentery. The bands were resected, and gastroduodenoscopy confirmed the resolution of the obstruction.

Discussion: We reviewed 93 cases of anomalous congenital bands, including the present one, comprising 33 adults and 60 children, with 71.0% of the cases involving males. Common symptoms included vomiting and abdominal pain, with physical examinations often showing tenderness and distension. Imaging techniques like plain x-ray, contrast x-ray, ultrasound, and computed tomography often indicated intestinal obstruction but were less effective in directly identifying congenital bands. All cases required abdominal surgery for diagnosis and treatment. Congenital bands were primarily found attached to the ileum or its mesentery and were resected in all cases, with a favorable postoperative prognosis. This case and the literature review provide valuable insights for clinical diagnosis and treatment.

References

Maeda A, Yokoi S, Kunou T, Tsuboi S, Niinomi N, Horisawa M . Intestinal obstruction in the terminal ileum caused by an anomalous congenital vascular band between the mesoappendix and the mesentery: report of a case. Surg Today. 2004; 34(9):793-5. DOI: 10.1007/s00595-004-2821-6. View

Asano S, Konuma K, RIKIMARU S, Inoue K . Volvulus of the transverse colon in a four-year-old boy. Z Kinderchir. 1982; 35(1):21-3. DOI: 10.1055/s-2008-1059893. View

Niang F, Nsia R, Faye I, Ndong A, Tendeng J, Diedhiou M . Small bowel obstruction due to congenital band in an adult: Radio-surgical correlation. Radiol Case Rep. 2023; 19(1):400-402. PMC: 10681875. DOI: 10.1016/j.radcr.2023.10.052. View

Low S, Ngiu C, Sridharan R, Lee Y . Midgut malrotation with congenital peritoneal band: a rare cause of small bowel obstruction in adulthood. BMJ Case Rep. 2014; 2014. PMC: 3948007. DOI: 10.1136/bcr-2013-202690. View

Cruise D, Goddard K . Congenital band adhesion causing a proximal jejunal obstruction: an uncommon presentation and diagnosis. BMJ Case Rep. 2019; 12(7). PMC: 6663212. DOI: 10.1136/bcr-2019-229235. View

Sharma D, Parameshwaran R, Dani T, Shetty P . Malrotation with transverse colon volvulus in early pregnancy: a rare cause for acute intestinal obstruction. BMJ Case Rep. 2013; 2013. PMC: 3762419. DOI: 10.1136/bcr-2013-200820. View

Just J, Bailey R . Duodenal obstruction from congenital bands: an unusual cause of pancreatitis. Can J Gastroenterol. 1996; 10(7):449-50. DOI: 10.1155/1996/738106. View

Arambepola D, Blades H, Sinha R, Sarma D . Therapeutic emergency laparoscopy for small bowel obstruction secondary to a congenital peritoneal band. Br J Hosp Med (Lond). 2022; 83(4):1-3. DOI: 10.12968/hmed.2021.0505. View

Yang K, Lee T, Lee S, Kim S, Cho Y, Kim H . Congenital adhesion band causing small bowel obstruction: What's the difference in various age groups, pediatric and adult patients?. BMC Surg. 2016; 16(1):79. PMC: 5142405. DOI: 10.1186/s12893-016-0196-4. View

10.

Machino K, Kondo K, Sato K, Imamura T, Ohsawa Y . Strangulated bowel obstruction by idiopathic congenital band in very low birthweight infant. Pediatr Int. 2022; 65(1):e15408. DOI: 10.1111/ped.15408. View

11.

Leung A, Yamamoto J, Luca P, Beaudry P, McKeen J . Congenital Bands with Intestinal Malrotation after Propylthiouracil Exposure in Early Pregnancy. Case Rep Endocrinol. 2015; 2015:789762. PMC: 4667016. DOI: 10.1155/2015/789762. View

12.

Guragai M, Bhusal S, Bhatta A . Intestinal Obstruction of Congenital Origin: A Case Report. JNMA J Nepal Med Assoc. 2020; 58(221):59-61. PMC: 7580479. View

13.

Naddouri J, Khouah R, Sekkat H, Bakali Y, El Alaoui M, Raiss M . Small bowel obstruction in adults, Ladd's band is an exceptional cause: a case report. Pan Afr Med J. 2024; 47:34. PMC: 10998253. DOI: 10.11604/pamj.2024.47.34.36435. View

14.

Vishnoi V, Park S, Martin P . Acute chylous peritonitis as a result of jejunal volvulus and small bowel obstruction from a congenital band adhesion. ANZ J Surg. 2018; 89(7-8):E345-E346. DOI: 10.1111/ans.14462. View

15.

Sarkar D, Gongidi P, Presenza T, Scattergood E . Intestinal obstruction from congenital bands at the proximal jejunum: a case report and literature review. J Clin Imaging Sci. 2013; 2:78. PMC: 3551515. DOI: 10.4103/2156-7514.105130. View

16.

Erginel B, Gun Soysal F, Ozbey H, Keskin E, Celik A, Karadag A . Small Bowel Obstruction due to Anomalous Congenital Bands in Children. Gastroenterol Res Pract. 2016; 2016:7364329. PMC: 4958424. DOI: 10.1155/2016/7364329. View

17.

Kumar A, Ramakrishnan T, Behl A, Sahu S, Singh G . Intestinal obstruction in a child: internal hernia caused by an anomalous congenital band. Trop Gastroenterol. 2011; 31(3):219-21. View

18.

Nouira F, Sarrai N, Charieg A, Jlidi S, Chaouachi B . Small bowel obstruction by an anomalous congenital band. Acta Chir Belg. 2012; 112(1):77-8. DOI: 10.1080/00015458.2012.11680801. View

19.

Abdelwahed Y, Saber R, Imen B, 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. PMC: 5128824. DOI: 10.1016/j.ijscr.2016.11.007. View

20.

Bani-Hani K, Shatnawi N . Meckel's diverticulum: comparison of incidental and symptomatic cases. World J Surg. 2004; 28(9):917-20. DOI: 10.1007/s00268-004-7512-3. View