Case Report: CT Diagnosis of Intestinal Obstruction Caused by a Primitive Band

Chorouk  Mountassir; Salaheddine Mouadib; Zineb Gourram; Mohamed Labied; Ghizlane Lembarki; Mouna Sabiri; Samira Lezar

doi:10.5455/ajdi.20250403092157

Abstract
We report the case of a 56-year-old woman with no significant medical or surgical history, who presented to the emergency department with diffuse abdominal pain, vomiting, and an inability to pass stool or gas. On physical examination, abdominal distension, tenderness, and decreased hydroaeric sounds were noted. Abdominal CT scan revealed significant jejunal distension, a "beak sign," and a fat notch, which were indicative of a mechanical small bowel obstruction due to a congenital fibrous band. Laparotomy confirmed the diagnosis of intestinal strangulation caused by the fibrous band, which was subsequently resected. The patient had an uneventful postoperative course. This case is unique due to the absence of any prior surgical history, highlighting that congenital fibrous bands can cause small bowel obstruction even in adults without previous abdominal surgery. The key takeaway for clinicians is the importance of considering congenital fibrous bands in the differential diagnosis of small bowel obstruction, particularly in patients without a history of abdominal surgery. Early diagnosis via imaging and timely surgical intervention are essential to prevent severe complications, such as intestinal necrosis.

Key words: Congenital Fibrous Band; Intestinal Obstruction; Computed Tomography; Case Report