Constipation in a 7-year-old Boy: Congenital Band Causing a Strangulated Small Bowel and Pulseless Electrical Activity

Fang, Andrea; Carnell, Jennifer; Stein, John C.

doi:10.1016/j.jemermed.2010.05.092

Cited by 10 publications

(9 citation statements)

References 21 publications

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“…A congenital band can be single vascular band or multiple dense or adhesive bands like our case [6][7][8][9]. According to previous related reports in the literatures, terminal ileum is the most common at the level of obstruction [4,6,7,[10][11][12]. SBO is mostly caused by compression of the bowel by the band, and may develop in case that intestinal loop is trapped band and the mesentery [2,12].…”

Section: Discussionmentioning

confidence: 95%

“…At the initial stage, signs and symptoms are indicative of intestinal obstruction, but chronic abdominal pain or constipation history may be observed in patients over two years of age. If patients admitted with these chronic symptoms are treated only with conservative therapy without thorough evaluation, they may lapse into a life-threatening condition [4]. Thus, clinicians should consider the potential occurrence of SBO with congenital band in patients with common symptoms such as nonbilious vomiting and abdominal cramping.…”

Section: Discussionmentioning

confidence: 99%

“…Thus, abdominal CT with intravenous contrast is frequently employed. CT scan can detect the etiology of obstruction in over three-fourths of cases and serve to exclude a strangulated bowel [4]. Although radiologic examination such as abdominal radiography or abdominal CT scans is likely to help to differentiate various diseases, it is not worthy of making a correct preoperative diagnosis of SBO resulting from a congenital band.…”

Section: Discussionmentioning

confidence: 99%

“…To prevent this aggravation, rapid diagnosis should be made by the upper gastrointestinal series or abdominal sonography. Abdominal computed tomography (CT) with intravenous contrast is frequently used as a method of additional radiologic studies for the identification of undiagnosed strangulation [3,4]. We report a 4-year-old male with the terminal ileal obstruction by an anomalous congenital band, who had no history of previous surgery.…”

Section: Introductionmentioning

confidence: 99%

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Small Bowel Obstruction Caused by an Aberrant Congenital Band in a Child

Kwak

Kang

Kim

et al. 2012

Pediatr Gastroenterol Hepatol Nutr

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Small bowel obstruction due to congenital band is not only rare in children, but also difficult to diagnose, because common symptoms such as vomiting and abdominal pain are observed in patients. In order to prevent a fatal result, an anomalous congenital band should be considered in the discriminative diagnosis of intestinal obstruction in children who have no previous experience of operation or intraperitoneal inflammation. This report presents a 4-year-old boy who was admitted with abdominal pain and nonbilious vomiting for a day. The initial suspicion was for acute gastroenteritis. However, after further investigation and performance of surgery, the intestinal obstruction associated with a congenital band was confirmed. No recurrence was observed during the 8-month follow-up period. Thus early confirmation based on radiologic study is a crucial factor for the diagnosis of small bowel obstruction caused by a congenital band. (Pediatr Gastroenterol Hepatol Nutr 2012; 15: 188∼192)

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Small Bowel Obstruction Caused by an Aberrant Congenital Band in a Child

Kwak

Kang

Kim

et al. 2012

Pediatr Gastroenterol Hepatol Nutr

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“…Constipation is one of the most common complaints faced by physicians and emergency departments. It accounts for nearly 5% of hospital visits and consists of a very broad set of differential diagnoses, including but not limited to bowel obstruction, neurogenic conditions, and congenital bands [ 1 ]. Although congenital bands that lead to intestinal obstruction are extremely rare, if not identified early enough, they can lead to dangerous and often life-threatening situations.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2016

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Case seriesPatients: Male, 33 • Male, 18 • Male, 19Final Diagnosis: Congenital band causing a small bowel obstructionSymptoms: Progressive abdominal pain that eventually becomes excessiveMedication: —Clinical Procedure: Laparoscopic band removalSpecialty: SurgeryObjective:Rare diseaseBackground: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 Reports: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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