ABSTRACT
A 15-month-old female with history of constipation and weight loss presents for evaluation. Symptoms began at 4 months of age when she was transitioned from breast milk to formula. She had two previous hospitalizations for fecal impaction that required clean out and has tried multiple oral laxatives without improvement. Clinic examination reveals a funnel shaped anal opening admitting a 10 Hagar dilator. Abdominal radiograph reveals significant pancolonic stool burden.
