Caeco-peritoneal band as a potential cause of right iliac fossa pain in children.

Abstract

A caeco-peritoneal band (CPB) has been observed during diagnostic laparoscopy for chronic right iliac fossa (RIF) pain. This has a veil-like configuration and arises along a broad base from the caecum and ascending colon and attaches to the anterior abdominal wall. Retrospective analysis of a prospectively collected database of 31 patients, aged 11-16, who underwent diagnostic laparoscopy for ongoing RIF pain over a 10-year period was analysed for intra-operative presence of the CPB. The patients' symptoms, past medical history, diagnostic workup, surgical findings and outcome were evaluated. CPB was identified in five patients. All presented with chronic RIF pain and had inconclusive preoperative investigations. Two patients underwent previous surgery. In all cases, the CPB was the sole abnormal finding on diagnostic laparoscopy. Symptoms resolved following division of the CPB with no recurrence of pain at a mean follow-up of 575days. CPB is a potential cause of chronic RIF pain in patients with unremarkable examination findings and negative serological and radiological investigations. Laparoscopic identification and division of the CPB has produced symptom resolution in this cohort of patients.