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Delayed presentation of multiple congenital intestinal webs

Yousef El-Gohary1, Caroline Chung2, Ghassan M Hammoud3

  • 1Division of Pediatric General, Thoracic and Fetal Surgery, Chidren's Hospital Univeristy of Missouri, Columbia, Missouri, USA yousef.gohary@health.missouri.edu.

BMJ Case Reports
|April 24, 2026
PubMed

Insights

Congenital intestinal webs are rare causes of bowel obstruction in adults. Failure of wireless capsule endoscope progression in adolescents may indicate multiple intestinal webs, requiring surgical intervention.

Area of Science:

  • Gastroenterology
  • Pediatric Surgery

Background:

  • Congenital intestinal webs are rare causes of mechanical bowel obstruction.
  • Adult presentation is uncommon and poses diagnostic challenges.
  • Adolescent presentation with chronic symptoms is particularly rare.

Purpose of the Study:

  • To report a rare case of multiple congenital intestinal webs in an adolescent.
  • To highlight the diagnostic utility of wireless capsule endoscopy in identifying intestinal webs.
  • To emphasize the importance of considering intestinal webs in pediatric patients with unexplained gastrointestinal symptoms.

Main Methods:

  • Case report of an adolescent patient with chronic abdominal pain, constipation, and iron deficiency anemia.
  • Diagnostic workup including evaluation for celiac disease, eosinophilic gastrointestinal disorders, and inflammatory bowel disease.
  • Wireless capsule endoscopy followed by laparoscopic-assisted retrieval and resection of intestinal webs.

Main Results:

  • The patient presented with symptoms refractory to initial treatments.
  • Wireless capsule endoscopy failed to progress, suggesting a small bowel obstruction.
  • Laparoscopic-assisted retrieval identified and resected 18 intestinal webs.
  • Surgical resection resulted in complete resolution of symptoms.

Conclusions:

  • Failure of wireless capsule endoscope progression in children and adolescents can be indicative of intestinal webs.
  • Intestinal webs, though rare, should be considered in the differential diagnosis of unexplained gastrointestinal issues in pediatric patients.
  • Early diagnosis and surgical management of intestinal webs lead to favorable outcomes.

Keywords:
EndoscopyHaematology (incl blood transfusion)Paediatric SurgeryPaediatricsSmall intestine

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