Anomalous congenital bands associated with necrotizing enterocolitis in a term neonate: A case report

Abstract

Introduction: We report a rare occurrence in which a term infant with intestinal anomalous congenital bands (ACB), presented with bloody stools and necrotizing enterocolitis (NEC), instead of the typical intestinal obstruction picture. Our case differs from the reported cases of ACB in its presentation as bloody stools and necrotizing enterocolitis, rather than the classic symptoms of intestinal obstruction (IO). Case presentation: A term neonate who was admitted to the Neonatal Intensive Care Unit (NICU) because of hypoglycemia, developed bloody stools and a clinical picture of NEC. She was treated by antibiotics and kept NPO for 7 days during which her symptoms resolved. Upon refeeding and after reaching full feeding volumes, her bloody stools recurred which warranted expanding the differential diagnosis and further investigations including lower gastrointestinal (GI) contrast study. The lower GI contrast study showed multiple filling defects indicating GI obstruction. Laparotomy was performed to explore and release the cause of obstruction. Laparotomy revealed Anomalous Congenital Bands (ACB) in the colon and cecum causing almost complete obstruction of the intestinal lumen. The ACB were excised, and the stricture segments of bowel were resected, and primary anastomosis was completed. Feeding was resumed with no recurrence of symptoms. Conclusion: Anomalous congenital bands may present with bloody stools and clinical picture of NEC rather that the classic presentation of intestinal obstruction.

Keywords

• Necrotizing enterocolitis
• Anomalous congenital bands
• Bloody stool
• Laparotomy
• Case report