CLINICAL HISTORY.—This 19-day-old infant was admitted to Childrens Hospital, Los Angeles, because of constipation since birth. During the past five days, she had only one bowel movement and this was with the aid of an enema. Vomiting, following feedings, had occurred in the week prior to admission. The vomitus was not bilestained. The remainder of the history and the family history were noncontributory.
Physical Examination.—The patient was an alert, vigorous infant in no distress. The pertinent findings were limited to the abdomen, which was protuberant, but soft. Multiple fecal masses were palpated. The findings of a rectal examination were "good sphincter tone and a large amount of soft, yellow-brown stool in the rectal ampulla. No obstruction was identified." The results of all laboratory studies were normal. A barium enema examination was performed.
Denouement and Discussion
(Aganglionic Megacolon)Even though the early onset of clinical disturbance in