EP.TU.193Omental band - A unusual cause of mechanical small bowel obstruction in a virgin abdomen

Abstract Introduction The small bowel obstruction in a non-operated abdomen is rare, and the most common causes are hernia neoplasm. complete mechanical due to an omental band patient with no previous abdominal surgery less than five cases have been reported literature. Case presentation We report 65 year old male presented emergency department complaints of pain, distension, vomiting obstipation for four days. On clinical examination, his was distended, diffusely tender, guarding. blood investigations showed elevated White cells neutrophils normal CRP Serum lactate. Abdominal X-ray suggestive SBO. Computed tomography pelvis marked dilatation jejunum, ileum entirely collapsed, impression double beak sign mid-abdomen which would suggest closed-loop possible internal hernia. proceeded diagnostic laparoscopy converted laparotomy, causing proximal obstruction. loops appeared congested constriction band. divided, relieved. Postoperatively recovered well discharged on day three post-op. Discussion timely diagnosis intervention could prevent complications like strangulation, ischemia gangrene. Though it should still be suspected as aetiology patients without prior surgery.