Case presentation A 9-year-old boy presented with a sudden onset of colicky, mainly infra-umbilical, abdominal pain of 4-hour duration. He had a grossly distended abdomen and experienced two episodes of non-bilious vomiting. His parents reported that he had normal bowel movements daily before joining the school, after which, the bowel movement became every 2-3 days.

The child had a similar attack, a month before the current presentation, and a rectal tube deflation was done in a hospital. Physical examination Physical examination revealed - ·         Tachycardia ·         Gross abdominal distention ·         Pain while holding the abdomen ·         No direct or rebound tenderness ·         The abdomen was hyper-tympanic to percussion ·         Elevated bowel sounds ·         No palpable mass on deep palpation ·         Per-rectum examination: o   Empty rectum o   No stool or blood on…