Pediatr Gastroenterol Hepatol Nutr.  2012 Sep;15(3):188-192.

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

• Kwak MH
• Kang JH
• Kim AS
• Choi SM
• Kim DK
• Lee DS
• Ha DY
• Kim SW

Abstract

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.

Keyword

Small bowel obstruction; Congenital band; Radiologic study

MeSH Terms

Abdominal Pain
Child
Follow-Up Studies
Gastroenteritis
Humans
Inflammation
Intestinal Obstruction
Preschool Child
Recurrence
Vomiting

Figure

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  Fig. 1 Standing abdominal radiograph shows dilated small bowel loops with air-fluid level in the left upper abdomen and lack of large bowel gas shadows.

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  Fig. 2 Transverse abdominal US (A) and the same level axial contrast enhanced abdomen computed tomography image (B) show incomplete rotation of collapsed small bowel loop and mesentery in the lower abdomen (black arrows) mimicking whirlpool appearance.

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  Fig. 3 Axial contrast-enhanced abdomen computed tomography image shows that superior mesenteric vein (SMV) branch (black arrow) travels counterclockwise around the superior mesenteric artery as it moves away from the SMV.

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  Fig. 4 Coronal multiplanar reformat computed tomography image shows collapsed proximal ascending colon (black arrow) with transition point in the terminal ileum (white arrow), and dilatation of fluid filled small bowel loops.

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