ABSTRACT
A 3-week-old boy presents with bile-stained vomiting and abdominal distention. He was delivered via normal vaginal delivery at 41 weeks. He first passed meconium at 72 hours. He has been exclusively breast-fed and has been having difficulty-passing stool. It is reported that he strains a lot and passes stool every 6 days. On physical examination, the patient is stable, saturating well on room air, but has an obvious distended abdomen that is non-tender and firm. Hernial orifices are clear. Rectal examination confirms a normally sited anus that admits a size 13 Hager. On removal of the Hagar, there is a large release of gas and stool. Abdominal x-ray reveals typical signs of distal bowel obstruction with no air in the rectum.
