Related Experiment Videos
Anomalous congenital bands causing intestinal obstruction in children
F M Akgür1, F C Tanyel, N Büyükpamukçu
1Department of Pediatric Surgery, Hacettepe University Children's Hospital, Ankara, Turkey.
Insights
Unexplained congenital bands can cause intestinal obstruction and chronic abdominal pain in children. These anomalous mesenteric bands, often containing blood vessels, require surgical intervention for relief.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Developmental Biology
Background:
- Intestinal obstruction is a significant surgical emergency in children.
- Congenital anomalies of the mesentery are a known, though less common, cause of intestinal obstruction.
- Chronic abdominal pain in children can have various etiologies, including surgical causes.
Purpose of the Study:
- To review cases of intestinal obstruction caused by anomalous congenital bands with no clear embryologic or acquired origin.
- To describe the clinical presentation, anatomical location, and obstructive mechanisms of these bands.
- To investigate the potential role of mesenteric anomalies in pediatric intestinal obstruction and chronic abdominal pain.
Main Methods:
- Retrospective review of medical records for eight pediatric patients.
- Analysis of patient demographics, clinical symptoms, surgical findings, and outcomes.
- Detailed examination of the characteristics and locations of the identified congenital bands.
Main Results:
- All eight patients presented with symptoms of intestinal obstruction.
- Patients over two years old also reported chronic abdominal pain.
- A single, thick, anomalous congenital band, containing blood vessels, was identified as the cause in each case.
- Common locations included the ascending colon/terminal ileum and ligament of Treitz/terminal ileum.
- Obstruction occurred via bowel compression or intestinal loop entrapment.
Conclusions:
- Anomalous congenital mesenteric bands are a potential cause of intestinal obstruction and chronic abdominal pain in children.
- These bands represent a distinct group of mesenteric anomalies.
- Further investigation into the embryogenesis of these bands is warranted.
Abstract:
The records of eight patients treated for intestinal obstruction resulting from bands that have no identifiable embryologic or acquired basis were reviewed retrospectively. All patients presented with symptoms and signs indicative of intestinal obstruction. Patients older than 2 years of age additionally had a history of chronic abdominal pain. One thick anomalous congenital band with blood vessels in it was found to be the cause of obstruction in each patient. Bands were located between ascending colon and terminal ileum in four patients (50%), ligament of Treitz and terminal ileum in two patients (25%), right lobe of liver and terminal ileum in one patient (12.5%), and right lobe of liver and ascending colon in one patient (12.5%). The obstructive mechanisms were compression of bowel by band in five patients (62.5%) and entrappment of an intestinal loop between the band and mesenterium in three patients (37.5%). These bands are suggested to be the anomalies of mesenterium that may cause intestinal obstruction and chronic abdominal pain in children.