Congenital Band Research Articles

Intestinal Obstruction of Congenital Origin: A Case Report

Congenital bands are rare causes of intestinal obstruction and often leads to diagnostic challenges. Diagnostic delays in cases of mechanical obstruction might lead to irreversible bowel ischemia and perforation. Presently described is a case of an 18 month young child with severe vomiting developed for one day. The child was initially thought to have acute viral enteritis and treated accordingly. Due to the severity, an X-Ray and computed tomography scan were sent which pointed towards the possibility of having congenital bands. He was treated operatively. The child was kept under observation for eleven days and was discharged. Although rare, intestinal obstruction due to congenital bands must be considered when treating a child with severe vomiting. Keywords: case reports, congenital abnormalities, intestinal obstruction, vomiting.

One stage release of circumferential constriction band in upper limb with multiple Z-plasty technique: a case report

INTRODUCTION: Congenital constriction band is an uncommon congenital abnormality with multiple disfiguring and disabling manifestations. The widely known management for the correction of congenital constriction band especially in circumferential constriction band is done in a multistage release of constriction band to eluding vascular and lymphatic embarrassment. The purpose of this case report was to present the outcome of one-stage release in terms of safety and aesthetic appearance. CASE DESCRIPTION:Women 28 year old came to outpatient plastic surgery clinic presented with circumferential constriction with no functional disability in her right arm since birth. Excision based on design of multiple Z-Plasty is started 2 cm proximal and distal from constricted band. The multiple Z- Plasty flaps are transposed around each other, changing the direction of the constriction band. Postoperatively, the extremity circulation was normal, and no edema was observed. The range of motion is within normal limits and aesthetically acceptable for the patient. DISCUSSION: Patterson classified constriction ring syndrome into four types, and type II is the most common. In type II Paterson , there are normal full-layer skin structures and no important nerve or blood vessel was affected so an incision completely encircling an extremity would not interfere with distal circulation and provided strong evidence that one-stage resection of constriction band could be performed. Using multiple Z-Plasty for constriction band release leads to improvement of functional and cosmetic appearance of the defect. CONCLUSION: A one-stage release of circumferential constriction band in the upper limb using multiple Z-Plasty is considered as a safe treatment with an aesthetically acceptable result for the patient

Analysis of Cases with Intestinal Obstruction Due to Pediatric Congenital Abdominal Bands. Single Center Experience

Analysis of Cases with Intestinal Obstruction Due to Pediatric Congenital Abdominal Bands. Single Center Experience

A Case of Bowel Obstruction Due to an Anomalous Congenital Band With Asymptomatic Meckel’s Diverticulum

A Case of Bowel Obstruction Due to an Anomalous Congenital Band With Asymptomatic Meckel’s Diverticulum

Barium impaction causing bowel obstruction in a neonate

Abstract Oral administration of barium sulfate can result in barium-induced intestinal obstruction. A term female newborn initially presented with a partial bowel obstruction. After completing an upper gastrointestinal (UGI) series with barium contrast to evaluate the etiology of her intestinal obstruction, she subsequently developed a complete bowel obstruction. At exploratory laparotomy, she was discovered to have a partial obstruction of the distal ileum by a congenital band that was rendered complete by an impacted barium plug. To our knowledge, this is the first report in a neonate with complete bowel obstruction secondary to barium impaction and the implications of this complication and appropriate management are discussed.

409. Small bowel obstruction secondary to congenital peritoneal band in pregnancy: A case study

Small bowel obstruction in pregnancy continues to be a rare and dangerous presentation, with the potential for fatal outcomes to both mother and foetus. As of yet, there is no consensus of management for this condition. We describe the case of a 40 year old IVF twin DCDA primigravida pregnancy, who presented at 20 weeks with abdominal pain and vomiting. Past surgical history included myomectomy. She was found to have small bowel obstruction and necrosis secondary to a congenital peritoneal band. A review of existing literature was conducted using several databases to compare previous management of similar conditions. The patient presented with epigastric pain, nausea and vomiting. On examination she was haemodynamically stable and both foetal heartbeats were heard. Initial management was medical, with intravenous fluids, anti-emetics and analgesia. Both pain and nausea worsened over 3 days. Abdominal ultrasound found prominent static bowel consistent with obstruction and the patient was referred urgently to the general surgeons. Further MRI confirmed the diagnosis. She underwent an emergency laparotomy, resection of small bowel (30 cm) and primary anastomosis. Recovery was complicated by post-operative ileus managed conservatively. She was discharged to complete a course of dalteparin during pregnancy and 6 weeks post-partum. The pregnancy continued to full term, delivering via elective C-section without issue at 37 weeks. Abdominal pain within pregnancy can offer a wide breadth of differentials and obstruction can be difficult to recognise. A low threshold for alternative diagnoses must therefore be kept for these examples. Equally, urgent imaging is key. Although contemporary management favours magnetic resonance (MR) imaging in order to minimise the effects of radiation on the foetus, organisation of this should not delay diagnosis and treatment. Ultrasound can be a useful alternative. Close partnership between surgical teams is also paramount.

Intestinal obstruction by congenital band

Intestinal obstruction by congenital band

Primary small intestinal volvulus after laparoscopic rectopexy for rectal prolapse

Primary small intestinal volvulus is defined as torsion in the absence of congenital malrotation, band, or postoperative adhesions. Its occurrence as an early postoperative complication is rare. A 40-year-old woman presented with rectal prolapse, and laparoscopic rectopexy was uneventfully performed. She could not have food on the day after surgery. She started oral intake on postoperative day 3 but developed abdominal pain after the meal. Contrast-enhanced CT revealed torsion of the small intestinal mesentery. An emergent laparotomy showed small intestinal volvulus, without congenital malformation or intestinal adhesions. We diagnosed it as primary small intestinal volvulus. The strangulated intestine was resected, and reconstruction was performed. The patient recovered uneventfully after the second surgery. To the best of our knowledge, this is the first report of primary small intestinal volvulus occurring after rectopexy for rectal prolapse. Primary small intestinal volvulus could be a postoperative complication after laparoscopy.

Pattern of congenital musculoskeletal anomalies in a suburban Nigerian tertiary hospital

Introduction: Available data in congenital musculoskeletal anomalies (MSAs) in Africa are sparse; hence, we decided to evaluate the pattern of congenital MSA as seen in Irrua Specialist Teaching Hospital (ISTH), Irrua, Edo state of Nigeria. Materials and Methods: The clinical records of patients who presented to ISTH with congenital MSA over 10 years (January 2005–December 2014) were extracted and reviewed. Demographic data, diagnosis, description of abnormalities, associated congenital deformities, side of the body involved, and bilaterality were noted. Results: Seventy-five patients met the criteria. Fifty patients were male and 25 were female. Male: female ratio was 2:1. Congenital talipes equinovarus (CTEV) deformity was the most common MSA in 46 (61.33%) patients. Others were syndactyly in 20 (26.7%) patients and congenital constriction band syndrome in 4 (5.3%) patients. Among patients with clubfoot were a predominance of bilaterality involved with 44.7% in the idiopathic group and 62.5% of those in the nonidiopathic group. The idiopathic variety constituted 82.5% of clubfoot deformity. Spina bifida cystica was the most common associated deformity among patients with nonidiopathic clubfoot. Conclusion: CTEV was the most common congenital MSA seen in ISTH, Irrua, with a high incidence of bilaterality. Spina bifida cystica was the most associated anomaly in the nonidiopathic clubfoot in this center.

Congenital Peritoneal Band Causing Bowel Ischaemia Post Caesarean Section: A Rare Occurrence

Congenital peritoneal band is an extremely rare condition, but may induce small bowel obstruction (SBO) at any age, predominantly in childhood and rarely in adults. We report a case of extensive bowel ischaemia following caesarean section, due to trapping of an intestinal loop between a congenital peritoneal band and the mesentery. A 42-year-old, Gravida 2 Para 1, who has no history of prior abdominal surgery or trauma, presented in spontaneous labour and underwent an uncomplicated emergency lower segment caesarean section, for fetal distress. Postoperatively, she had worsening abdominal distension and pain, followed by vomiting. Computed Tomography Scan of the abdomen showed gross fluid retention with marked small bowel dilatation and fluid filled bowel loops. An emergency exploratory laparotomy was performed which revealed a congenital band, extending between the right fimbrial end and the small bowel mesentery, looping over the small bowel, causing extensive small bowel ischemia. Postoperative course was uneventful. In conclusion, congenital peritoneal band causing small bowel obstruction, although rare, should be considered in the differential, especially for patients with virgin abdomen.

Imaging Findings of the Unusual Presentations, Associations and Clinical Mimics of Acute Appendicitis.

There are many kinds of unusual presentations or associations and clinical mimics of acute appendicitis, and definitive diagnosis requires knowledge of the imaging findings in some cases. The unusual presentations and associations of acute appendicitis included in this study are perforated appendicitis, acute appendicitis occurring in hernias, acute appendicitis with cystic endosalpingiosis, intussusception of appendix, and acute appendicitis with pregnancy. We also present uncommon gastrointestinal, urinary and gynecologic clinical mimics of acute appendicitis including anomalous congenital band, duplication cysts, giant Meckel's diverticulitis, inflammatory fibroid polyp, renal artery thrombosis, spontaneous urinary extravasation and OHVIRA syndrome. Familiarity with these entities may improve diagnostic accuracy and enable the quickest and most appropriate clinical management.

Spectrum of neonatal surgical emergency- a study in rural area tertiary care center of western U.P

Introduction: Neonatal Intestinal obstruction is commonest surgical cause in emergency, in which rapid intervention is required to prevent undesirable side effect of obstruction that includes death. This study provides spectrum of intestinal obstruction in neonates and sex prediction. Material and Method: This is prospective study done in neonates with feature of intestinal obstruction attending emergency and outdoor of Pediatrics Surgery, Pediatrics Medicine and General Surgery of U.P.U.M.S , Saifai, Etawah during period of January 2016–December 2016. Result: During the study period of one year total 44 patents admitted to our side with features of neonatal obstruction in which male female ratio was 3.8:1. Out of these 44 neonates Anorectal malformation was found in 61.36% neonates, Hirschsprung’s Disease in 9.09%, Duodenal obstruction in 6.81%, Hernia of umbilical cord in 4.54%, Atresia in 4.54, Congenital peritoneal band in 2.27%, Meconium obstruction in 2.27%, Malrotation in 2.27%, Meckel’s band obstruction in 2.27%, Ileal knotting in 2.27%, Idiopathic hypertrophic pyloric stenosis (IHPS) in 2.27%. Conclusion: Early identification and surgical management in neonatal intestinal obstruction decrease morbidity and motilities in neonates. Reason of male sex predominance is not known, it may be due to less attention towards female child by social custom in our society.

RETRACTED: Amniotic Band Syndrome With Pseudoarthrosis of Tibia and Fibula: A Case Report

Constriction of the lower limb by a congenital amniotic band has been proposed to explain the development of pseudoarthrosis of the tibia and fibula. We report a case of amniotic band syndrome in a preterm female infant with pseudoarthrosis of the tibia and fibula. She was born at 29weeks of gestation with congenital amniotic bands and was noted to have a severely edematous left foot distal to the constricting band with rudimentary digits. The skin was pink and well perfused with palpable pulses. Radiography demonstrated pseudoarthrosis of the tibia and fibula. The limb deformities were managed with splints, positioning, and physiotherapy. She underwent Z-plasty with soft tissue release on the left lower leg on day 7 of life. At 36weeks of postmenstrual age, a repeat radiograph showed markedly improved growth of the tibia and fibula with mature new bone formation, which avoided the need for further surgical intervention. During the follow-up period, she underwent left Syme's amputation at 18months. At 29months of age, the child was able to walk and run without support. The findings from our case confirm the potential for bone growth in patients with amniotic band syndrome, once the constricting band has been released. Simple release of the constriction band with Z-plasty resulted in growth of mature bone, replacing the pseudoarthrosis and, hence, the patient did not require surgical amputation. Thus, one should be cautious when deciding on surgical amputation, even in the presence of pseudoarthrosis, especially in preterm infants. Early limb-preserving surgery with release of the constricting band with an intention to salvage the limb appears appropriate.

Bride mésentérique congénitale simulant un volvulus de l’intestin grêle sur anomalie de rotation mésentérique

A congenital mesenteric band is a rare cause of intestinal obstruction. We describe a case of upper gastrointestinal obstruction on a jejunal congenital band in a 2-year-old child. The challenge is to make the diagnosis in a patient with no history of previous surgery.

Congenital anomaly band, a rare cause of intestinal obstruction in children. Case report

Abstract Background Intestinal obstruction in children may be congenital, acquired, intrinsic or extrinsic. Most intestinal obstructions in children are the result of postoperative adhesions. Those caused by anomalous congenital band are extremely rare. Clinical case Patient of a 1-year-old male, with no previous history of abdominal surgery or trauma. He suffered with vomiting of bile content and loss of appetite at home three days before admission. On physical examination, he was irritable, with abdominal distention, absence of peristalsis and abdominal tenderness, with no signs of peritoneal irritation being found. The blood count reported leucocytosis and the x-rays show dilated small bowel loops, fluid levels and absence of air in rectal ampulla. An open laparotomy was subsequently performed, and the intraoperative findings were consistent with a congenital band extending from the anti-mesenteric wall of the jejunum to the root of mesentery, compressing the ileum at 50 cm from the ileocecal valve, causing ischaemia. The band was ligated and divided, with an uneventful postoperative course. He was discharged 4 days later without complications. Conclusions The anomalous congenital band is not associated with abdominal problems, such as remnants of previous laparotomies or embryological structures, such as vitelline vessels or omphalomesenteric yolk duct. These bands seem to have a congenital origin and cause bowel obstruction by trapping between the band and the mesentery. The diagnosis of anomalous congenital band is extremely difficult and no imaging study is useful for the diagnosis, and only exploratory laparotomy or laparoscopy is useful for diagnosis and treatment of this problem.

Primary renal mature cystic teratoma in an infant: A rare case presenting with an acute intestinal obstruction

Primary renal teratomas are uncommon and preoperative diagnosis is difficult. Additional pathologies may be more difficult to diagnosis and may increase morbidity. We are reporting a case of large primary renal cystic teratoma which was presented with acute intestinal obstruction due to congenital band at ileum. Patient was successfully managed by dividing the congenital band and excision of teratoma in toto. Pathologic examination showed evidence for a primary renal mature teratoma. Serum alpha-fetoprotein is a reliable method of assessing recurrence.

Dört Aylık Bir Çocukta Barsak Tıkanıklığına Neden Olan Doğumsal İntraabdominal Bant

Intestinal obstruction due to compression of bowels by a congenital intraabdominal band is a rarely seen clinical picture in childhood. Herein, we presented a 4-month-old patient who admitted our emergency service with symptoms and signs of intestinal obstruction. Urgent laparotomy revealed, a band compressing terminal ileum lead to intestinal obstruction. There is not any intestinal ischemia or necrosis. Following surgical exploration, the band was transected and intestinal passage was restored. The patient is asymptomatic for 2 years after the surgery. This case showed that congenital band compression should be kept in mind in differential diagnosis of intestinal obstruction during infancy. In addition, appropriate surgical approach ensures a successful outcome.

Lipoinjection and Multiple Internal Cuts for Congenital Constriction Bands: A New Treatment Approach

BackgroundTraditional treatment for a congenital constriction band of the limb involves multiple Z-plasties and W-plasties. We propose an alternative surgical procedure for the treatment of congenital constriction bands that obviates the need for Z-plasties and eliminates the constriction band.MethodsWe present the case of a 36-year-old woman with a congenital constriction band of the leg. Using a minimally invasive approach, the skin segment that included the band was dissected from the deep tissues. Afterwards, multiple slices were performed on the internal surface of the fibrous ring. This and lipoinjection were used to reverse the depression that characterizes the “hourglass sign” and homogenize the skin surface.ResultsResults have remained stable in a follow-up period of 18 months.ConclusionsThis surgical alternative can be considered as an option for the treatment of congenital constriction bands. It is a safe, reproducible procedure that does not cause additional scars and has good functional and aesthetic results.Level of evidence VThis journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Congenital adhesion band causing small bowel obstruction: What's the difference in various age groups, pediatric and adult patients?

BackgroundA 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.MethodsThe 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.ResultsOf 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.ConclusionsCongenital 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.

The prevalence of amnion rupture sequence, limb body wall defects and body wall defects in Alberta 1980-2012 with a review of risk factors and familial cases.

Prevalence rates of amnion rupture sequence, limb body wall defect, and body wall defects vary widely. Comparisons are difficult due to small case numbers and the lack of agreement of definition, classification, and pathogenesis. This study reports the prevalence of cases classified in five distinct categories. The Alberta Congenital Anomalies Surveillance System data on live births, stillbirths, and terminations of pregnancy (<20 weeks gestation) occurring between 1980 through 2012 with the ICD-10 Royal College of Paediatrics and Child Health Adaptation codes used for congenital constriction bands (Q79.80) and body wall complex (Q89.7) were reviewed. During the 33-year-study period, there were 153 eligible cases ascertained from 1,411,652 live births and stillbirths, giving a prevalence of 1.08/10,000 total births. There were more males (52%) than females (45%) and 3% were of unknown sex. The average maternal age, birth weight, and gestation was 27 years, 2,701 g, and 35 weeks, respectively. Limb deficiencies occurred in 78% of cases. Amniotic bands with limb deficiency was the most common phenotype (48%). Digital limb deficiency was the most frequent type (56%); however, cases with body wall defects had more severe types of limb deficiencies. The upper limbs only were affected more times (44%), and there was no side preference. Most cases are sporadic but a number of familial occurrences have been reported although some have insufficient documentation and others misdiagnosed. A review of putative risk factors gives conflicting results. © 2016 Wiley Periodicals, Inc.