A case of small bowel obstruction in a 4-year-old boy with pica is described. The child habitually chewed on his plastic toy action figures. Abdominal radiography and endoscopy confirmed the presence of chewed pieces of plastic within the digestive tract. At surgery, the cause of the obstruction was found to be an internal hernia involving a congenital fibrous band connecting 2 segments of the jejunum and unrelated to pica. Intestinal obstruction caused by foreign bodies is extremely rare, and obstruction caused by congenital bands is even more uncommon. This particular variant of a congenital band has not been previously described. Physicians should be aware that congenital bands can cause small bowel obstruction in children and that surgical treatment is required.
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