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A 3-year-old boy without relevant family diseases and delayed meconium passage after birth has had chronic constipation since infancy, interspersed sometimes with normal passage of soft sausage-like stools. He experienced several episodes of abdominal distension or enterocolitis which caused dehydration requiring hospitalisation. On admission, the patient, weighing 13 kg (30th percentile), had abdominal fullness, but normal haemogram and biochemical parameters. Contrast enema identified an apple-core lesion (figure 1A) at the terminal ileum but an otherwise normal colon with noticeable peristaltic waves. CT identified wall thickening of the terminal ileum with mesenteric lymphadenopathy (figure …
Contributors J-CC treated the patient, wrote the manuscript and constructed the figures. CH took photographs of the tissue sections.
Funding This work was supported by Chang Gung Memorial Hospital, Taoyuan, Taiwan (CMRPG3K0431-2).
Competing interests None declared.
Provenance and peer review Not commissioned; internally peer reviewed.