Case Reports in Medicine

Case Reports in Medicine / 2009 / Article

Case Report | Open Access

Volume 2009 |Article ID 825174 | 3 pages | https://doi.org/10.1155/2009/825174

Congenital Circumferential Constriction Band of the Abdomen: A Case Report

Academic Editor: Frans J. Walther
Received11 Oct 2009
Accepted21 Dec 2009
Published08 Feb 2010

Abstract

We report a case of congenital constriction band of abdomen associated with limb pseudarthrosis. The constriction band around the abdomen, though may cause initial difficulty with ventilation and parental distress, does not interfere with feeding, bowel movements, and growth. It heals spontaneously with supportive treatment though surgery may be needed in some cases.

1. Introduction

Though several hundred cases of congenital constriction band of the limbs have been described, that of abdomen is rare and only ten cases have been reported in the literature.

2. Case Report

A 31-week preterm baby was noted at birth to have a deep circumferential constriction band of the abdomen (Figure 1). There was also a deep constriction ring involving the right leg that resulted in a pseudoarthrosis below knee (Figure 3). The clinical appearance of the abdomen was striking and initially appeared to interfere with breathing requiring ventilation on high pressures, but there were no mechanical problems affecting feeding or neurological pressure symptoms. In the absence of symptoms after the first few weeks, surgical correction using multiple Z-plasties was planned before school age. However, since he presented before that with abdominal pain, surgery was undertaken at 2 years of age (Figures 1 and 2). A transtibial (below knee) amputation was required for functional management of the right leg deformity (Figure 4).

3. Discussion

The overall reported prevalence of amniotic bands in the UK and Western Europe varies between 0.44 to 0.48 (per 10,000 births) [1]. Circumferential congenital constriction band of the abdomen is extremely rare [24]. Some common characteristics of the congenital constriction band of the abdomen have been described [5]. The constriction band follows a single segment that is higher on the back. The constriction ring may be located above or below the pelvic brim. The depth varies from a shallow groove to a deep gutter and usually extends only up to the first fascial layer. Histologically, the constriction bands are made of abundance of acellular fibrous tissue, or fibrous tissue containing fibroblasts, covered by squamous cells. This can make them inelastic and can produce a ligature effect. There may or may not be other associated congenital abnormalities.

To the best of our knowledge, only 10 published cases of congenital constriction band involving the abdomen, with or without associated abnormalities, have been described (Table 1).


AuthorYearLocation to pelvic brimSexOther abnormalities

Brown et al. 1957below M None
Schneider et al. 1976below F Pilonodal sinus Cleft of soft palate
Evans 1973above F None
Izumi et al. 1971above M Band around 2 toes and club foot
Casaubon et al. 1983above F None
Jones 1986above M Limb defects
Bahadoran et al. 1997 above F None
Lin et al. 1999above M None
Kim et al. 2007above F Ring constriction of the left leg, absent hallux
Fawzy et al. 2008below F Constriction bands on both calves, congenital amputations of toes

Despite the alarming appearance, abdominal bands do not seem to cause mechanical problems [3]. Whilst the “hour glass” deformity can improve with time, plastic surgery may still be required as the abdominal contents expand or for cosmesis (Figure 1).

References

  1. EUROCAT Website Database, December 2008, http://eurocat.ulster.ac.uk/.
  2. D. M. Evans, “Congenital ring constriction of the trunk,” British Journal of Plastic Surgery, vol. 26, no. 4, pp. 340–343, 1973. View at: Publisher Site | Google Scholar
  3. J. B. Kim, M. G. Berry, and J. S. Watson, “Abdominal constriction band: a rare location for amniotic band syndrome,” Journal of Plastic, Reconstructive and Aesthetic Surgery, vol. 60, no. 11, pp. 1241–1243, 2007. View at: Publisher Site | Google Scholar
  4. M. Fawzy, P. Goon, and A. M. Logan, “Letter to the editor,” Journal of Plastic, Reconstructive and Aesthetic Surgery, vol. 62, no. 3, pp. 416–417, 2009. View at: Publisher Site | Google Scholar
  5. Ph. Bahadoran, J.-Ph. Lacour, A. Terrisse, and J.-P. Ortonne, “Congenital constriction band of the trunk,” Pediatric Dermatology, vol. 14, no. 6, pp. 470–472, 1997. View at: Publisher Site | Google Scholar

Copyright © 2009 Kapil Gargh et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


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