Anomalous congenital band causing duodenal and transverse colon obstruction in a 3-year-old girl: A case report

Introduction

Intestinal obstruction is commonly seen in children and may result from various acquired or congenital causes. Obstruction due to an anomalous congenital band (ACB) is exceptionally rare. These bands can develop anywhere along the gastrointestinal tract and often pose a diagnostic challenge preoperatively.

Case presentation

A 3-year-old girl presented with chronic constipation, abdominal pain, and bilious vomiting. She was initially diagnosed and treated for conditions such as simple constipation, cystitis, enteritis, and gastritis, but showed no improvement. The radiological evaluation included abdominal radiography, ultrasound, dual-contrast computed tomography (CT), and a single-contrast enhanced image of the upper gastrointestinal tract (GIT). Surgical intervention was undertaken based on CT and upper GIT contrast imaging findings indicating an obstruction in the second part of the duodenum. Operative findings revealed an ACB arising from the root of the small intestinal mesentery, obstructing both the duodenum and the transverse colon. The band was divided, and a portion of it was sent for histopathological examination. The postoperative period was uneventful, her symptoms fully resolved, and she was discharged on the 6th postoperative day. At the 2-month follow-up, she remained asymptomatic. To our knowledge, no such case has previously been documented in the literature.

Conclusion

Anomalous congenital bands should be considered in the differential diagnosis of children presenting with intestinal obstruction in the absence of previous abdominal operations, particularly when preoperative imaging findings are inconclusive.