Clinical History.—This female infant born at home after an apparently normal pregnancy, and labor was quickly transferred to a hospital. The weight was 2,600 gm (5 lb 11¾ oz). Condition at birth was good; resuscitation was not needed. On the second day of life she refused a feeding and soon afterwards vomited mucus and small amounts of coffee-ground material. Placed in an oxygen tent, she was transferred to another hospital for surgery.
Physical Examination.—On admission, the infant
weighed 2,360 gm (5 lb 3½ oz), looked ill and was slightly jaundiced. Rectal temperature was 96.8 F (36 C); pulse rate, 180 beats per minute; respiratory rate, 60 breaths per minute. The abdomen was very distended, and bowel sounds were absent. Normal respiratory sounds were transmitted to the abdomen. Liver dullness was absent. Laboratory findings were normal. Intravenous therapy including sodium ampicillin was started immediately. Films were obtained. Surgery was