Late-presenting congenital ileal stenosis causing neonatal distal bowel obstruction: a case report and focused review of the literature
- 1Department of Pediatric Surgery “Hichem Said”, Children’s Hospital of Tunis, University Tunis El Manar, Tunis, Tunisia
- 2Department of Visceral and Digestive Surgery, Traumatology and Great Burns Center, Ben Arous, Tunisia, University of Tunis El Manar, Tunis, Tunisia
- 3Pathology Department, Salah Azaiez Institute, University of Tunis El Manar, Tunis, Tunisia
Abstract
Introduction:: Congenital intestinal stenosis is an uncommon congenital anomaly characterized by partial narrowing of the intestinal lumen, unlike jejunoileal atresia, which results in complete luminal interruption. Because intestinal transit is only partially impaired, clinical presentation may be delayed and intermittent, making diagnosis challenging.
Presentation of case:: A full-term male neonate presented on day 19 of life with bilious vomiting, abdominal distension, and failure to pass stools after a period of normal bowel transit. Initial radiological investigations excluded malrotation and did not demonstrate features suggestive of Hirschsprung disease. Conservative management resulted in transient clinical improvement, allowing discharge. Five days later, the patient was readmitted with recurrent bilious vomiting progressing to feculent emesis and signs of systemic compromise. Exploratory laparotomy revealed congenital distal ileal stenosis located 45 cm proximal to the ileocecal valve. Resection of the stenotic segment, tapering of the dilated proximal bowel, and primary end-to-end anastomosis were performed. The postoperative course was uneventful.
Discussion:: Congenital ileal stenosis remains a rare and often misleading cause of neonatal intestinal obstruction. Unlike complete atresia, stenosis may present with delayed or intermittent symptoms, normal meconium passage, and initially reassuring imaging findings. Review of published case reports demonstrates that the diagnosis is frequently established only during surgical exploration.
Conclusion:: Congenital ileal stenosis should be considered in neonates presenting with recurrent or delayed clinical presentations despite inconclusive imaging studies. Persistent or recurrent obstructive symptoms should prompt early surgical reassessment.
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BibTeX
@article{marzouki2026latepresenting,
title = {{Late-presenting congenital ileal stenosis causing neonatal distal bowel obstruction: a case report and focused review of the literature}},
author = {Mariam Marzouki and Malek Mezni and Yosra Ben Ahmed and Imen Ben Ismail and Aya Khemir and Said Jlidi},
journal = {International Journal of Surgery Case Reports},
year = {2026},
month = sep,
doi = {10.1097/rc9.0000000000001011},
url = {https://doi.org/10.1097/rc9.0000000000001011},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Late-presenting congenital ileal stenosis causing neonatal distal bowel obstruction: a case report and focused review of the literature
AU - Mariam Marzouki
AU - Malek Mezni
AU - Yosra Ben Ahmed
AU - Imen Ben Ismail
AU - Aya Khemir
AU - Said Jlidi
PY - 2026
DA - 2026/09/29
JO - International Journal of Surgery Case Reports
DO - 10.1097/rc9.0000000000001011
UR - https://doi.org/10.1097/rc9.0000000000001011
AB - Introduction:: Congenital intestinal stenosis is an uncommon congenital anomaly characterized by partial narrowing of the intestinal lumen, unlike jejunoileal atresia, which results in complete luminal interruption. Because intestinal transit is only partially impaired, clinical presentation may be delayed and intermittent, making diagnosis challenging. Presentation of case:: A full-term male neonate presented on day 19 of life with bilious vomiting, abdominal distension, and failure to pass stools after a period of normal bowel transit. Initial radiological investigations excluded malrotation and did not demonstrate features suggestive of Hirschsprung disease. Conservative management resulted in transient clinical improvement, allowing discharge. Five days later, the patient was readmitted with recurrent bilious vomiting progressing to feculent emesis and signs of systemic compromise. Exploratory laparotomy revealed congenital distal ileal stenosis located 45 cm proximal to the ileocecal valve. Resection of the stenotic segment, tapering of the dilated proximal bowel, and primary end-to-end anastomosis were performed. The postoperative course was uneventful. Discussion:: Congenital ileal stenosis remains a rare and often misleading cause of neonatal intestinal obstruction. Unlike complete atresia, stenosis may present with delayed or intermittent symptoms, normal meconium passage, and initially reassuring imaging findings. Review of published case reports demonstrates that the diagnosis is frequently established only during surgical exploration. Conclusion:: Congenital ileal stenosis should be considered in neonates presenting with recurrent or delayed clinical presentations despite inconclusive imaging studies. Persistent or recurrent obstructive symptoms should prompt early surgical reassessment.
SN - 2210-2612
ER -