Small Bowel Obstruction By Anomalous Band In An Elderly Patient

Abstract

Acute Intestinal obstruction is one of the commonest surgical emergencies encountered. They are most frequently caused by adhesions followed by hernias, tumors, intussusception, foreign bodies, gallstones, and inflammatory bowel disease. We report a case of small intestinal obstruction in an 83 year old lady caused by anomalous band. A contrast enhanced computed tomography scan  of abdomen revealed  solitary, small GB calculi, dilated and distended small bowel  loops, multiple level narrowing seen in distal jejunum and proximal ileum; No evidence of gall stone ileus or mesenteric ischemia. The patient was taken up for emergency laparotomy wherein she was found to have an abnormal band arising from right iliac fossa extending upto left sacro-iliac joint region causing small intestinal obstruction by constricting the loops at various levels.There was no evidence of any bowel gangrene or vascular compression by the band. No evidence of perforation. The band was resected and abdomen closed in layers. A congenital band causing small bowel obstruction and becoming symptomatic so late in life is extremely rare. A literature search for bands causing small bowel obstruction in an elderly (Eg., in 83 years old) showed no reports. Possibly our case may be the first case in literature.