Appendiceal band syndrome in an 8-year-old patient: a case report

Small bowel obstruction (SBO) secondary to appendiceal band syndrome is an exceptionally rare surgical condition in children. An 8-year-old boy presented with a 3-day history of progressive abdominal distension, frequent episodes of bilious vomiting, and failure to pass feces and flatus. Physical examination revealed a distended, tender abdomen without a palpable mass. Laboratory investigations showed leukocytosis (WBC 15,000/mm 3 ) with 88 % neutrophils, while hemoglobin and platelet counts were within normal limits. Abdominal radiography demonstrated multiple dilated small bowel loops consistent with mechanical obstruction. After initial resuscitation and nasogastric decompression, an exploratory laparotomy was performed. Intraoperatively, the distal 35 cm of the ileum was found to be constricted by the perforated tip of the appendix, which had formed a fibrous band attaching to the adjacent small bowel mesentery. The involved bowel segment was viable, and an appendectomy alone was sufficient. The postoperative course was uneventful, with satisfactory urine output and early return of bowel function. The patient was discharged home in good condition on the second postoperative day. Appendiceal band syndrome must be included in the differential diagnosis of children who develop a small bowel obstruction.