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07 October 2016 : Case report  Lebanon

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

Challenging differential diagnosis, Management of emergency care, Rare disease, Congenital defects / diseases, Educational Purpose (only if useful for a systematic review or synthesis)

Gregory NicolasABCDEF, Tony KfouryABEFG, Rasha ShimlatiABCDF, Elliott KouryABDE, Maroon TohmehDE, Elie GhariosCDG, Raja WakimBCEG

DOI: 10.12659/AJCR.899664

Am J Case Rep 2016; 17:712-719

Abstract

BACKGROUND: 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 REPORT: 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.

Keywords: general surgery, Hand-Assisted Laparoscopy, Laparotomy

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923