title: Congenital adhesion band causing small bowel obstruction: What's the difference in various age groups, pediatric and adult patients?
abstract: BACKGROUND
  A congenital adhesion band is a rare condition, but may induce a small bowel obstruction (SBO) at any age. However, only a few sporadic case reports exit. We aimed to identify the clinical characteristics of congenital adhesion band manifesting a SBO stratified by age group between pediatric and adult patients.
  
  
  METHODS
  The medical records of all patients with a SBO between Jan 1, 2009 and Dec 31, 2015 were retrospectively reviewed. Cases associated with previous surgical procedure and cases of secondary obstruction due to inflammatory processes or tumor and other systemic diseases were excluded. The patients were divided into two groups according to age below or above 18 years: pediatric and adult. The basic clinical characteristics were analyzed and compared between groups.
  
  
  RESULTS
  Of 251 patients with a SBO, 15 (5.9%) met the inclusion criteria; 10 cases in pediatric group (mean age 17.9 ± 38.7 months) and 5 cases in adult group (mean age 60.0 ± 19.7 years). The pediatric group (66.6%) included 3 neonates, 5 infants, and 2 school children. They usually presented with bilious vomiting (50.0%) and abdominal distention (60.0%), and demonstrated a high rate of early operation (80.0%) and bowel resection (70.0%). In contrast, the adult group (33.3%) presented with abdominal pain (100%) in all cases and underwent a relatively simple procedure of band release using a laparoscopic approach (60%). However, group differences did not reach statistical significance. In addition, two groups did not differ in the time interval to the operation or in the range of the operation (p = 0.089 vs. p = 0.329). No significant correlation was found between the time interval to the operation and the necessity of bowel resection (p = 0.136). There was no mortality in either group.
  
  
  CONCLUSIONS
  Congenital adhesion band is a very rare condition with diverse clinical presentations across ages. Unlike adult patients, pediatric patients showed a high proportion of early operation and bowel resection. A good result can be expected with an early diagnosis and prompt management regardless of age.
authors.affiliation: Department of Surgery, Pusan National University Yangsan Hospital, Yangsan, Korea.|Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea.
authors.forename: Kwang-Ho
authors.initials: KH
authors.lastname: Yang
authors.affiliation: Department of Surgery, Pusan National University Yangsan Hospital, Yangsan, Korea.
authors.forename: Tae-Beom
authors.initials: TB
authors.lastname: Lee
authors.affiliation: Department of Surgery, Pusan National University Yangsan Hospital, Yangsan, Korea.
authors.forename: Si-Hak
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Department of Surgery, Pusan National University Yangsan Hospital, Yangsan, Korea.
authors.forename: Soo-Hong
authors.initials: SH
authors.lastname: Kim
authors.affiliation: Department of Surgery, Pusan National University Yangsan Hospital, Yangsan, Korea. choyh70@pusan.ac.kr.|Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea. choyh70@pusan.ac.kr.|Department of Surgery, Pusan National University School of Medicine, Geumo-ro 20, Mulgeum-eup, 50612, Yangsan, Gyeongnam, Korea. choyh70@pusan.ac.kr.
authors.forename: Yong-Hoon
authors.initials: YH
authors.lastname: Cho
authors.affiliation: Department of Surgery, Pusan National University Yangsan Hospital, Yangsan, Korea.
authors.forename: Hae-Young
authors.initials: HY
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000652:Amniotic Band Syndrome / Q000150:complications*; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007415:Intestinal Obstruction / Q000453:epidemiology* / Q000209:etiology / Q000601:surgery; D007421:Intestine, Small / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D000267:Tissue Adhesions / Q000150:complications
keywords: Adult; Congenital adhesion band; Obstruction; Pediatric