Congenital band as a rare cause of small bowel obstruction: a case series and review of the literature

INTRODUCTION: Small bowel obstruction (SBO) is a common surgical emergency, most often caused by adhesions, whereas congenital peritoneal bands (CPBs) represent a rare etiology in adults. Limited contemporary data exist, with most adult series reporting fewer than ten cases. This study describes seven adult patients treated for CPB-related SBO and compares their characteristics and outcomes with those in the literature. METHODS: A retrospective review was conducted of adult patients presenting with SBO due to congenital bands at a single tertiary center between 2010 and 2022. Inclusion criteria were age ≥ 18 years, imaging-confirmed SBO, intraoperative confirmation of a congenital band, and a virgin abdomen. Clinical, radiologic, and operative data were collected. A narrative review of the literature was performed for comparison. RESULTS: Seven of 269 SBO admissions (2.6%) involved congenital bands. Mean age was 37.1 years, and all patients presented with abdominal pain and vomiting. CT identified a transition point in all cases, though no band was visualized. All patients underwent laparoscopic exploration; six required simple band division, whereas one patient required conversion and ileal resection for ischemia. Mean hospital stay was 3.7 days, with no postoperative complications or recurrence. Compared with the literature, our series demonstrates a lower conversion and resection rate and represents one of the largest contemporary adult cohorts. CONCLUSION: Congenital bands, though rare, should be considered in adult SBO when no prior abdominal surgery is present. Early laparoscopic exploration provides accurate diagnosis and effective treatment with low morbidity.