Constipation in a 7-year-old boy: congenital band causing a strangulated small bowel and pulseless electrical activity.
BACKGROUND
Constipation in pediatric patients is a common diagnosis in the emergency department (ED) and may occasionally arise from a significant underlying illness.


OBJECTIVE
To discuss a rare cause of constipation that led to a strangulated small bowel and cardiac arrest.


METHODS
A 7-year-old boy presented in pulseless electrical activity. The patient had been seen in the ED 2 days prior with the complaint of abdominal pain, which was diagnosed as constipation. The boy had emigrated from Mexico 18 months earlier. The patient was resuscitated in the ED and taken emergently to the operating room. During surgery he was discovered to have a congenital abdominal adhesive band that led to a strangulated small bowel. He suffered subsequent multi-organ failure, including hypoxic ischemic encephalopathy, and was hospitalized for 5 months. One month after discharge he was improving and being followed by multiple providers.


CONCLUSIONS
Congenital adhesive bands, although rare, may be life-threatening anomalies. We present this case to increase awareness of this condition among emergency physicians.
Fang
Andrea C
AC
Department of Emergency Medicine, University of California, San Francisco, San Francisco, California 94143, USA.
Carnell
Jennifer
J
Stein
John C
JC
D002302:Cardiac Output; D002648:Child; D003248:Constipation / Q000209:etiology*; D006323:Heart Arrest / Q000209:etiology*; D006801:Humans; D007415:Intestinal Obstruction / Q000151:congenital*; D007421:Intestine, Small / Q000002:abnormalities*; D008297:Male; D009102:Multiple Organ Failure / Q000209:etiology