Jejunal web as the cause of bowel obstruction in a toddler: Case report and brief literature review

• Published in: International journal of surgery case reports Vol. 87; p. 106455
• Main Authors: Khoei, Samin, Borhani, Ali, Ghavamiadel, Maryam, Zamani, Fatemeh
• Format: Journal Article
• Language: English
• Published: Elsevier Ltd 01.10.2021; Elsevier
• Subjects: Bowel obstruction; Case Report; CT-scan; Jejunal web; Pediatric imaging; Pediatric surgery; CT-scan; Bowel obstruction; Case report; Pediatric imaging; Pediatric surgery; Jejunal web
• ISSN: 2210-2612; 2210-2612
• DOI: 10.1016/j.ijscr.2021.106455

Intestinal webs which are categorized under type-1 intestinal atresia rarely occur in the jejunum. These webs are occasionally diagnosed late because their central fenestration allows the passage of food. We report a toddler who presented with atypical symptoms of bowel obstruction and non-specific plain radiograph and ultrasound findings. The diagnosis of jejunal obstruction was made possible with contrast-enhanced computed tomography and obstruction was found to be the result of a jejunal web at the surgery. Few cases of jejunal webs are reported in the literature. The jejunum is the site of only 8% of webs and 33% of jejunal webs are associated with other congenital anomalies and/or prematurity. Jejunal web needs a high degree of suspicion to be diagnosed and should be kept in mind as a differential diagnosis in the setting of unexplained persistent non-bilious emesis in otherwise normal toddlers. •Jejunum is the site of 8% of webs and 33% of jejunal webs are associated with other congenital anomalies and/or prematurity.•Jejunal webs may become only intermittently symptomatic because their central fenestration allows passage of food.•Vascular, Re-canalization, disrupted endodermal development and hyper-proliferation theories are proposed as their etiology•Intra-operative endoscopy for localizing and resection of jejunal webs is a new approach in the treatment of this entity.