Ladd bands are the most commonly encountered form of peritoneal bands in disarrangement of intestines, e.g. intestinal malrotation.
Their relevance lies in predisposition to
- intestinal obstruction by internal hernias or volvulus
- intestinal infection within an extra compartment, e.g. fever of unknown origin
They are usually not visualized directly unless very extensive. Indirect visualization by small bowel pass through studies is possible. The intestinal malformation may be visualized by CT, pass through studies, US and MRI.
History and etymology
These "mesenteric attachments" were first described as a cause of congenital duodenal obstruction by American surgeon William E Ladd (1880-1967) in 1932 5. In this publication, he attributed disease to an embryologic failure of rotation. The surgical procedure for removal of these peritoneal bands is known as Ladd's procedure 4.
Ladd is considered a father of pediatric surgery, and co-founded the division of pediatric surgery at Boston Children's Hospital in 1910. Although most commonly remembered for his work investigating intestinal malrotation, Ladd also developed surgical treatment for pyloric stenosis and was the first to advocate use of contrast enema (originally bisthmus contrast) for diagnosis and treatment of intussusception 6.
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- 2. Kamal IM. Defusing the intra-abdominal ticking bomb: intestinal malrotation in children. CMAJ. 2000;162 (9): 1315-7. Free text at pubmed - Pubmed citation
- 3. Appaji AC, Kulkarni R, Kadaba JS. Nonrotation of intestine: a case report. J Clin Diagn Res. 2013;7 (11): 2575-6. doi:10.7860/JCDR/2013/6177.3616 - Free text at pubmed - Pubmed citation
- 4. Ladd W. New England Journal of Medicine. 1932;206 (6):277-283. doi:10.1056/NEJM193202112060604
- 5. Nakayama DK. William Ladd before the Halifax explosion. (2017) Journal of pediatric surgery. 52 (12): 2093-2096. doi:10.1016/j.jpedsurg.2017.08.047 - Pubmed
- 6. Lim, P, Martin ND, Hicks BA, Yeo CJ, Cowan, SW, "William Edwards Ladd, M.D. (1880-1967): the description of his bands." (2013). Department of Surgery , Gibbon Society Historical Profiles. Paper 15. PDF