DOI: https://doi.org/10.36347/sasjs.2026.v12i05.029

Pages: 484-486

Small bowel obstruction (SBO) is a common surgical emergency, most frequently caused by postoperative adhesions. However, primary adhesive bands occurring in patients without previous abdominal surgery are rare and may represent a diagnostic challenge. We report the case of a 48-year-old male patient with no past medical or surgical history, admitted for complete cessation of stool and flatus for five days. Clinical examination revealed abdominal distension with an empty rectal ampulla on digital rectal examination. Laboratory investigations showed leukocytosis (18,460/mm³), elevated C-reactive protein (98 mg/L), and hyponatremia (127 mmol/L). Abdominal computed tomography demonstrated small bowel obstruction likely caused by an adhesive band, associated with minimal peritoneal fluid. Emergency surgical exploration revealed diffuse small bowel dilatation proximal to a primary adhesive band located approximately 150 cm from the ligament of Treitz, with viable bowel and no evidence of ischemia. Surgical management consisted of adhesiolysis associated with bowel decompression. Postoperative recovery was uneventful, with restoration of bowel transit on postoperative day 2 and discharge on day 3. This case highlights that primary adhesive bands, although rare, should be considered even in patients without previous surgical history.