Delayed presentation of multiple congenital intestinal webs.

Congenital intestinal webs of the bowel are an exceedingly rare cause of mechanical bowel obstruction in adults. Their presentation beyond the neonatal period is rare and may represent a diagnostic challenge. We report a case of multiple intestinal webs in an adolescent patient who initially presented with chronic abdominal pain, constipation and iron deficiency anaemia refractory to oral supplementation. The patient underwent evaluation for multiple gastrointestinal pathologies, including coeliac disease, eosinophilic gastrointestinal disorders and inflammatory bowel disease. As part of the evaluation, the patient underwent wireless capsule endoscopy. However, the capsule failed to progress beyond the small bowel. Laparoscopic-assisted retrieval revealed 18 intestinal webs which were surgically resected with subsequent resolution of symptoms. Although rare, failure of progression of a wireless capsule endoscope should raise concerns of possible intestinal webs in children as an underlying aetiology. Intestinal strictures should be further investigated and multiple webs must always be ruled out.