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Colonic web in infants and toddlers: a cause of chronic bowel obstruction

Gaurav Prasad1, Nishant Godwin Xess1, Abhishek Ranjan2

  • 1Paediatric Surgery, Rajendra Institute of Medical Sciences, Ranchi, JH, India.

BMJ Case Reports
|July 14, 2025
PubMed

Insights

Delayed presentation of colonic web in infants and toddlers can cause bowel obstruction. Surgical intervention, including web excision, led to successful outcomes in two pediatric cases, emphasizing early diagnosis and follow-up.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Medical Diagnostics

Background:

  • Colonic web, a rare congenital anomaly, typically presents in neonates.
  • Delayed diagnosis in older children presents significant challenges.
  • Symptoms include chronic constipation, abdominal distension, and failure to thrive.

Purpose of the Study:

  • To report two cases of delayed presentation of colonic web in pediatric patients.
  • To highlight diagnostic and therapeutic challenges associated with late-onset colonic web.
  • To emphasize the importance of a broad differential diagnosis and careful follow-up.

Main Methods:

  • Case report of two pediatric patients (infant and toddler) with obstructive bowel symptoms.
  • Diagnostic workup including imaging and exploratory laparotomy.
  • Surgical management involving web excision and diversion colostomy.

Main Results:

  • Exploratory laparotomy confirmed colonic web in both patients.
  • Successful surgical excision of the colonic web and diversion colostomy were performed.
  • Both patients showed significant clinical improvement post-operatively with uneventful recovery.

Conclusions:

  • Delayed presentation of colonic web requires a high index of suspicion in pediatric patients with obstructive symptoms.
  • Imaging and intraoperative findings are crucial for diagnosis.
  • Postoperative follow-up is essential to rule out coexisting conditions like Hirschsprung Disease.

Keywords:
Paediatric SurgeryPediatrics

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