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The patient is a young child with three days of constipation with a non-specific history of abdominal pain. On exam, the child was asleep. The abdomen was easily palpable and soft.

View the x-ray taken (Figure 1) and consider what your diagnosis and next steps would be. Resolution of the case is described below.

Clinical Challenge 2: June 2007

Nahum Kovalski, BSc, MDCM

Clinical Researcher at TEREM Emergency Services