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Small bowel obstruction caused by a congenital jejuno-jejuno band in a child

Michael W Itagaki1, Ricardo Lema, James S Gregory

  • 1College of Medicine, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA.

Pediatric Emergency Care
|October 11, 2005
PubMed

Insights

A rare case of pediatric small bowel obstruction occurred in a 4-year-old boy. The obstruction was caused by a unique congenital band, unrelated to his pica behavior of chewing plastic toys.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Congenital Abnormalities

Background:

  • Small bowel obstruction is a serious condition in children.
  • Pica, the compulsive consumption of non-food items, can lead to gastrointestinal issues.
  • Congenital anomalies of the small intestine are a known cause of obstruction.

Observation:

  • A 4-year-old boy with pica presented with symptoms of small bowel obstruction.
  • Radiography and endoscopy revealed chewed plastic fragments in the digestive tract.
  • Surgical exploration identified an internal hernia due to a previously undescribed congenital fibrous band.

Findings:

  • The primary cause of obstruction was a congenital fibrous band creating an internal hernia.
  • The patient's pica and ingestion of plastic were incidental findings, not the cause of the obstruction.
  • This specific type of congenital band causing internal hernia has not been previously documented.

Implications:

  • Congenital bands represent an uncommon but critical cause of pediatric small bowel obstruction.
  • Physicians must consider congenital anomalies in the differential diagnosis of pediatric intestinal obstruction, even in the presence of pica.
  • Prompt surgical intervention is necessary for obstructions caused by congenital bands.

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