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Ladd's bands in older children, adolescents, and adults.

Abstract Congenital extrinsic duodenal bands (Ladd's bands) were encountered in 4 patients aged ten to twenty-six years. Common to all were dilatation, increased peristalsis, and obstruction of the duodenum, signs more marked in the upright position. Fluoroscopic and cine findings were of prime importance for diagnosis in 3 patients. At surgery the obstructive bands were not recognized until the entire region was fully exposed by mobilization of the right colon. The entire duodenum was freed, and in one case a duodenojejunostomy was performed. The hypothesis that the so-called “superior mesenteric artery syndrome” and duodenal obstruction by “Ladd's bands” are identical conditions is discussed.