Chandigarh, July 21, 2025 – When 15-year-old Abeer (name changed) started experiencing sudden abdominal pain and vomiting greenish fluid, his parents were naturally concerned. At first, they thought it was a routine stomach infection. But the reality was far more serious—and rooted in a condition he was treated for as a baby.
Abeer was born in a district of Himachal Pradesh. He was a full-term baby, at just two months old, he began showing symptoms such as persistent vomiting, feeding intolerance, and poor weight gain. He was diagnosed with a rare congenital condition called intestinal malrotation, where the intestines develop in the wrong position inside the abdomen. This condition affects approximately 1 in every 2,000 live births and, if left untreated, can lead to a dangerous complication known as volvulus, where the intestines twist and block the blood supply.
What makes this condition particularly challenging is that it often cannot be detected on standard prenatal anomaly scans. “Unlike heart or spine defects, this condition doesn’t produce obvious abnormalities during fetal development,” explained Dr. Ashish Dharmik, Consultant – Paediatric Neonatal Surgery, Motherhood Chaitanya Hospital, Sec 44, Chandigarh “The bowel is present and moving, so the scan often appears normal. Subtle mispositioning of the intestines just isn’t easy to pick up in utero.”
Abeer underwent corrective surgery called Ladd’s procedure at the time and made a steady recovery in 7 days, was discharged in stable condition.
For the next 15 years, Abeer was healthy and thriving—until recently, when he began vomiting and couldn’t keep any food down. Doctors quickly identified a blockage in his small intestine. This time, the problem was caused by adhesions—bands of internal scar tissue that can form after surgery.
“Adhesions are like cobwebs inside the abdomen,” explained Dr. Ashish Dharmik, Consultant – Paediatric Neonatal Surgery, Motherhood Chaitanya Hospital, Sec 44, Chandigarh. “When someone has had abdominal surgery, even years ago, some tissues inside the belly can stick together. Over time, this can cause blockage, preventing food and fluids from passing through the intestine.”
Doctors first tried to manage Abeer’s condition with fluids and medications for about 5–7 days. However, when these treatments didn’t work, surgery was the only option.
During the operation, Dr. Dharmik found thick scar tissue stuck around the intestines, along with a narrowed section of the small intestine called the jejunum. “We had to gently separate all the stuck areas to free the intestines,” said Dr. Dharmik. “Then we removed the narrowed portion and joined the healthy parts together so everything could function normally again.”
Abeer recovered well after surgery—he resumed soft foods within days and was discharged in stable condition. Stitches were to be removed on day 10, with follow-ups scheduled thereafter,
While adhesive intestinal obstruction can happen after any abdominal surgery, it is relatively rare for it to present 13–15 years later, especially in adolescents. The risk of such complications is estimated to be between 1% to 5% after abdominal procedures in infancy. Dr. Ashish Dharmik emphasized that this case is a reminder for parents to stay alert. “If your baby vomits frequently, doesn’t gain weight properly, or seems to have feeding issues, it’s important to get them checked. Conditions like malrotation are rare, but when caught early, they can be treated safely. Even in older children, if there’s frequent stomach pain that doesn’t go away or isn’t explained by infection or diet, further tests may be needed. If left undetected, such blockages can lead to malnutrition or even emergencies requiring immediate surgery.”
This case is a powerful reminder of how certain congenital conditions, though treated early, may carry long-term implications. It highlights the importance of timely diagnosis, surgical expertise, and parental awareness.
