Late-Onset Presentation of the Jejunal Web: A Case Report and Review of the Literature

Abstract

Introduction: The congenital intestinal web is a rare cause of small bowel obstruction classified as type I intestinal atresia. The second portion of the duodenum is the most prevalent site for these webs, whereas the jejunal web is rare. Case presentation: In this study, we present a very uncommon late presentation of the jejunal web in an 18-month-old girl complaining of chronic recurrent vomiting, constipation, and failure to thrive (FTT). After thorough investigations, the diagnosis was confirmed by the small bowel follow-through. The surgical procedure resulted in a significant improvement in patient’s quality of life, given the subsequent increase in her weight and height. Conclusions: Vomiting that occurs at any age is pathologic and requires careful history taking thorough clinical examination and evaluation, especially in patients treated with proton pump inhibitors such as omeprazole for a long time with a diagnosis of gastroesophageal reflux disease (GERD) without any response. In these patients, gastrointestinal abnormalities, including complete or incomplete obstructions such as malrotation and web, should be made in the differential diagnosis.