Introduction: Congenital anomaly band is an extremely rare condition, but may induce small bowel obstruction (SBO) at any age, predominantly in childhood and rarely in adults.

Methodology: We report a case of extensive bowel ischaemia following caesarean section, due to trapping of an intestinal loop between a congenital anomaly band and the mesentery.

Results: A 42 year old, Gravida 2 Para 1, who has no history of prior abdominal surgery or trauma, presented in spontaneous labour and underwent an uncomplicated emergency lower segment caesarean section, for fetal distress. Postoperatively, she had worsening abdominal distension and pain, followed by vomiting. Computed Tomography Scan of the abdomen showed gross fluid retention with marked small bowel dilatation and fluid filled bowel loops. An emergency exploratory laparotomy was performed which revealed a congenital band, extending between the right fimbrial end and the small bowel mesentery, looping over the small bowel, causing extensive small bowel ischemia. Post-operative course was uneventful.

Conclusion: Congenital anomalous band resulting in small bowel obstruction is a rare entity that should be considered in the differential in patients with clinical features of bowel obstruction, and no prior history of abdominal surgery or trauma. Surgical treatment should be prompt to prevent ischaemia and reduce morbidity and mortality.

Keywords: Bowel ischaemia, congenital band, bowel obstruction