A child who vomited for two years

Management of intestinal obstruction in the neonate

“…A digital rectal examination, which will allow passage of meconium by dilating the narrow rectum, sometimes solves the problem temporarily. Here a plain radiograph of the abdomen will show dilated bowel loops right up to the pelvis and no gas in the rectum 3 . A baby with this clinical scenario who improves on digital rectal examination or a bowel wash needs to be followed up, because a baby who shows temporary improvement like that might be quite asymptomatic while being on breast milk in the first 4 months as the stools are soft and not bulky; however once weaned the baby tends to get symptoms again as the stool consistency become bulky and somewhat thick.…”

“…In Hirschsprung disease the absence of ganglion cells in the nerve plexuses in the large bowel causes a functional obstruction which occurs in the rectosigmoid area in about 85% of the babies with this condition 3 . This causes a distal colonic obstruction which manifests as no passage of meconium, abdominal distension and vomiting 3 .…”