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A 12-day-old male neonate presented in the emergency room with constipation for three days and repeated episodes of non-bilious vomiting for one day. The patient had a history of delayed passage of meconium (after 48 hours) at birth. On examination, the abdomen was distended but soft, and bowel sounds present. X-ray abdomen showed multiple air-fluid levels. Suspecting Hirschsprung’s disease, saline enema was started. The patient started passing the stool and the abdominal distension settled down, thus feeding was resumed. The patient tolerated the feeds and started passing stool without enema. The patient was discharged and followed-up in the outpatient department (OPD). After two weeks, the patient again presented with abdominal distension and constipation. Rectal washout was given but the patient passed small amount of stool and abdominal distension persisted. Contrast enema performed showed narrow lumen of the entire colon, and the contrast could not pass proximal to the ileocecal junction (Fig.1A).

Ileocecal web with central perforation in a neonate: A peculiar inclusion to the scarce literature of ileocecal valve anomaly