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Congenital adhesion band causing small bowel obstruction: What's the difference in various age groups, pediatric and
Kwang-Ho Yang1,2, Tae-Beom Lee1, Si-Hak Lee1
1Department of Surgery, Pusan National University Yangsan Hospital, Yangsan, Korea.
Insights
Congenital adhesion bands rarely cause small bowel obstruction (SBO). Pediatric patients often require early surgery and bowel resection, unlike adults. Early diagnosis and prompt management are key for good outcomes in SBO cases.
Area of Science:
- Gastroenterology
- Pediatric Surgery
- Abdominal Surgery
Background:
- Congenital adhesion bands are a rare cause of small bowel obstruction (SBO).
- Sporadic case reports exist, highlighting the need for further clinical characterization.
- Understanding clinical differences in SBO due to congenital bands across age groups is crucial.
Purpose of the Study:
- To identify and compare the clinical characteristics of congenital adhesion bands causing SBO in pediatric versus adult patients.
- To stratify SBO presentation and management based on age groups.
Main Methods:
- Retrospective review of medical records for SBO cases between 2009 and 2015.
- Exclusion of SBO secondary to surgery, inflammation, tumors, or systemic diseases.
- Patients were divided into pediatric (<18 years) and adult groups for comparative analysis.
Main Results:
- Fifteen cases (5.9%) of SBO due to congenital adhesion bands were identified.
- Pediatric patients (n=10) presented with vomiting and distention, requiring early operation (80%) and bowel resection (70%).
- Adult patients (n=5) presented with abdominal pain, often treated with laparoscopic band release (60%). No statistically significant group differences in outcomes were observed.
Conclusions:
- Congenital adhesion bands present diversely in SBO across pediatric and adult populations.
- Pediatric patients demonstrate a higher propensity for early surgical intervention and bowel resection.
- Early diagnosis and prompt management are essential for favorable outcomes in SBO caused by congenital adhesion bands.
Background:
A congenital adhesion band is a rare condition, but may induce a small bowel obstruction (SBO) at any age. However, only a few sporadic case reports exit. We aimed to identify the clinical characteristics of congenital adhesion band manifesting a SBO stratified by age group between pediatric and adult patients.
Methods:
The medical records of all patients with a SBO between Jan 1, 2009 and Dec 31, 2015 were retrospectively reviewed. Cases associated with previous surgical procedure and cases of secondary obstruction due to inflammatory processes or tumor and other systemic diseases were excluded. The patients were divided into two groups according to age below or above 18 years: pediatric and adult. The basic clinical characteristics were analyzed and compared between groups.
Results:
Of 251 patients with a SBO, 15 (5.9%) met the inclusion criteria; 10 cases in pediatric group (mean age 17.9 ± 38.7 months) and 5 cases in adult group (mean age 60.0 ± 19.7 years). The pediatric group (66.6%) included 3 neonates, 5 infants, and 2 school children. They usually presented with bilious vomiting (50.0%) and abdominal distention (60.0%), and demonstrated a high rate of early operation (80.0%) and bowel resection (70.0%). In contrast, the adult group (33.3%) presented with abdominal pain (100%) in all cases and underwent a relatively simple procedure of band release using a laparoscopic approach (60%). However, group differences did not reach statistical significance. In addition, two groups did not differ in the time interval to the operation or in the range of the operation (p = 0.089 vs. p = 0.329). No significant correlation was found between the time interval to the operation and the necessity of bowel resection (p = 0.136). There was no mortality in either group.
Conclusions:
Congenital adhesion band is a very rare condition with diverse clinical presentations across ages. Unlike adult patients, pediatric patients showed a high proportion of early operation and bowel resection. A good result can be expected with an early diagnosis and prompt management regardless of age.
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