CLINICAL HISTORY.—An 18-hour-old girl was transferred to the Los Angeles Children's Hospital because of vomiting and pronounced abdominal distention. The infant had voided normally, but had not passed any meconium. This was the mother's first pregnancy; delivery had been at term, without difficulty.
When examined, the infant was well developed and vigorous, but had abdominal distention and hyperactive bowel sounds. Abnormal findings were not detected by rectal examination.
Supine and erect films of the abdomen were obtained (Fig 1). No signs of free intraperitoneal air or calcifications were visualized. A barium enema was performed and the contrast medium flowed readily into the colon. The appendix was filled, and only a small amount was refluxed into the terminal ileum (Fig 2). The infant vomited large amounts of bile-stained material. Surgery was performed 18 hours after admission.
Denouement and Discussion
ATRESIA OF THE ILEUM
At the time of surgery,