Small bowel obstruction due to Ladd band

Case contributed by Ian Bickle


Abdominal distension. Ultrasound indicated a bowel obstruction.

Patient Data

Age: 6 months
Gender: Male

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.

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