Delayed presentation of multiple congenital intestinal webs.

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.