Presentation
Abdominal distension. Ultrasound indicated a bowel obstruction.
Patient Data
Multiple dilated loops of small bowel in the abdomen and pelvis.
The large bowel is collapsed.
No pneumoperitoneum.
Case Discussion
Small bowel obstruction is a relatively uncommon surgical problem in those under 1 year of age.
CT studies of the abdomen in this age group are cautiously undertaken and can be challenging to interpret in view of the absence of inherent intra-abdominal fat. As well as confirming the diagnosis, one is trying to establish the potential cause and if a perforation has occurred prior to surgery.
In this case the intra-operative findings confirmed a high grade distal small bowel obstruction, which was caused by a congenital Ladd band. These are fibrous bands of peritoneal tissue which encircle the bowel causing obstruction.