Congenital band adhesion causing a proximal jejunal obstruction: an uncommon presentation and diagnosis

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.

Intestinal Obstruction of Congenital Origin: A Case Report

“…5 But, laparoscopic surgery would have allowed a relatively safer and effective treatment. 4 We have concluded that mechanical obstruction due to congenital bands must also be considered as a differential when children present with acute onset of excessive vomiting. A plain radiograph of the abdomen must be sent whenever in doubt and CECT must be performed to establish a diagnosis.…”

“… 2 Although congenital bands that lead to intestinal obstruction are very rare, 3 a delay in the diagnosis could lead to irreversible bowel ischemia and perforation and presents a surgical emergency. 4 …”