The rare presentations of bowel obstruction in infancy period

Introduction: Recurrent enterocolitis with failure to thrive during neonatal and infancy period are common manifestations of immunodeficiency, especially when associated with delayed separation of the umbilical cord. But in rare cases, these manifestations are associated with surgical causes as bowel obstruction, which will be missed because of the similarity of the clinical picture. Objective: To present a case of bowel obstruction which was missed under diagnoses of immunodeficiency, in the pediatric and surgical department at subspecialty children hospital. Case related: Our case is about 5 months old girl with failure to thrive, has a history of delayed separation of umbilical cord for 7 weeks, neonatal infection with recurrent enterocolitis needed hospitalization for a period of 3 months. She presented with fever, vomiting, diarrhea, distended abdomen. Each time the symptoms of vomiting and abdominal distention were improved after conservative management with the antibiotic, which delayed the diagnosis of bowel obstruction. After the surgery, all her symptoms resolved, and she began to thrive. Conclusion: Infants with bowel obstruction may present with vague symptoms make the diagnosis difficult, and delay the surgical intervention.