Anomalous Congenital Bands- An Unusual Cause of Neonatal Intestinal Obstruction

Intestinal obstruction is a common surgical problem in the neonatal period. Some of the common causes are intestinal atresia, meconium ileus, malrotation with volvulus, intussusception and Hirschprungs disease. Anomalous congenital bands, though rare should also be included in the differential diagnosis. We report a 23 day old female neonate who presented with abdominal distention and vomiting of two days duration and was treated as late onset sepsis with toxic ileus with shock. Neonates condition worsened with increasing abdominal distention and copious bilious aspirate and investigations were suggestive of distal small bowel obstruction. An emergency lapratomy done revealed hemoperitoneum and an anomalous congenital band in the region of terminal ileum causing obstruction and gangrene involving 20 cms. of ileum from eight cms. proximal to ileocecal junction. Adhesions were released, band lysis was done and gangrenous segment of bowel was resected . Proximal dilated end and distal end were brought out as ostomies.