Asian Journal of Case Reports in Surgery

Aims: Proximal small bowel atresia is a rare congenital condition that requires early surgical correction. Postoperative complications such as anastomotic strictures and adhesive obstructions are well-documented; however, foreign body-induced obstruction at an anastomotic site is rare. This case highlights an unusual etiology of bowel obstruction in a young child with a history of jejunal atresia repair, emphasizing the need to consider uncommon causes when evaluating persistent gastrointestinal symptoms.

Case Presentation: We report a case of a 3-year-old girl presenting with abdominal distension and sub-occlusive symptoms, characterized by stool cessation but continued gas passage. Her medical history included neonatal surgery for complete jejunal atresia. Imaging studies suggested a possible anastomotic stricture, but definitive diagnosis remained unclear. Exploratory laparotomy revealed extensive adhesions and a localized obstruction at the previous anastomotic site, caused by a calcified date pit. The foreign body was successfully removed via enterotomy, and the anastomotic site was confirmed to be patent. The patient recovered uneventfully, with resolution of obstructive symptoms.

Discussion: While anastomotic strictures are a well-recognized complication following small bowel atresia repair, foreign body obstruction at an anastomotic site is uncommon, especially in young children. This case underscores the importance of considering alternative diagnoses when clinical and radiological findings are inconclusive.

Conclusion: This report highlights the need for thorough evaluation in cases of unexplained bowel obstruction post-surgery. When standard diagnostic modalities fail to provide clarity, exploratory surgery remains a crucial tool for identifying rare causes of obstruction and guiding appropriate management.