Ladd's bands, sometimes called bands of Ladd, are fibrous stalks of

peritoneal The peritoneum is the serous membrane forming the lining of the abdominal cavity or coelom in amniotes and some invertebrates, such as annelids. It covers most of the intra-abdominal (or coelomic) organs, and is composed of a layer of mesothe ...

tissue that attach the

cecum The cecum or caecum is a pouch within the peritoneum that is considered to be the beginning of the large intestine. It is typically located on the right side of the body (the same side of the body as the appendix (anatomy), appendix, to which i ...

to the retroperitoneum in the right lower quadrant (RLQ). Obstructing Ladd's Bands are associated with

malrotation Intestinal malrotation is a congenital anomaly of rotation of the midgut. It occurs during the first trimester as the fetal gut undergoes a complex series of growth and development. Malrotation can lead to a dangerous complication called volvulus. ...

of the

intestine The gastrointestinal tract (GI tract, digestive tract, alimentary canal) is the tract or passageway of the digestive system that leads from the mouth to the anus. The GI tract contains all the major organs of the digestive system, in humans ...

, a developmental disorder in which the cecum is found in the right upper quadrant (RUQ), instead of its normal anatomical position in the RLQ. Ladd's bands then pass over the second part of the duodenum, causing extrinsic compression and obstruction. This clinically manifests as poor feeding and bilious vomiting in neonates. Screening can be performed with an upper GI series. The most severe complication of malrotation is midgut volvulus, in which the mesenteric base twists around the superior mesenteric artery, compromising intestinal perfusion, leading to bowel necrosis. A surgical operation called a "Ladd procedure" is performed to alleviate intestinal malrotation. The procedure involves counterclockwise detorsion of the bowel, surgical division of Ladd's bands, widening of the

small intestine The small intestine or small bowel is an organ in the gastrointestinal tract where most of the absorption of nutrients from food takes place. It lies between the stomach and large intestine, and receives bile and pancreatic juice through the p ...

mesentery The mesentery is an organ that attaches the intestines to the posterior abdominal wall in humans and is formed by the double fold of peritoneum. It helps in storing fat and allowing blood vessels, lymphatics, and nerves to supply the intestines ...

, performing an

appendectomy An appendectomy, also termed appendicectomy, is a Surgery, surgical operation in which the vermiform appendix (a portion of the intestine) is removed. Appendectomy is normally performed as an urgent or emergency procedure to treat complicated acu ...

, and reorientation of the small bowel on the right and the cecum and colon on the left (the appendectomy is performed so as not to be confused by atypical presentation of appendicitis at a later date). Most Ladd surgical repairs take place in infancy or childhood. Ladd's bands and the Ladd procedure are named after American pediatric surgeon William Edwards Ladd (1880–1967).

References

External links

Children's Hospital Boston, Intestinal malrotation

Ladd's bands {{anatomy-stub