Fact-sheet: Ladd bands
Updated on 04/23/2019 at 9:56 AM
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Definition
Rare congenital malformation: peritoneal band stretched between the cecum and the right posterior abdominal wall, passing over the second portion of the duodenum.
Clinical features
Asymptomatic as long as the incomplete common mesentery remains uncomplicated.
High-grade bowel obstruction.
Symptoms in neonates, infants, or even in adults.
Laboratory findings
Unremarkable.
Radiography
Upper GI series and water-soluble contrast enema: diagnosis of incomplete common mesentery (cecum in the right hypochondrium, pre-duodenal, with the ligament of Treitz in an abnormal position (not on the left).
Ultrasound
Incomplete common mesentery: cecum and mesenteric vessels not in normal position.
CT
Confirmation of the underlying anatomic anomaly: incomplete common mesentery.
High-grade bowel obstruction (transition zone at the second portion of the duodenum).
Visualization of signs of a band: beak sign / whirl sign / rotation almost always clockwise.
MRI
no
Vascular intervention
no
Nuclear medicine
no
Management
Surgical emergency in cases of bowel obstruction.
Asymptomatic band: surgical indication.
Differential diagnosis
Obstruction due to a non-congenital adhesion.