היצרות מלידה של המעי הכרוך (אילאום): ביטוי קליני מאוחר לחשד טרום לידה מוקדם

INTRODUCTION: Congenital stenosis (partial obstruction) of the small intestine is uncommon in comparison to atresia (complete obstruction). The clinical manifestations of stenosis could be delayed up to several weeks post-delivery. We present a case wherein a baby with a prenatal ultrasound examination showed a suspicious picture of small bowel obstruction. However, the clinical manifestations after delivery and imaging studies were misleading and non-classic; therefore, the resection of the stenotic portion of the ileum was delayed until the baby was one month of age. After the operation the baby stopped vomiting but diarrhea continued. The infant's formula was changed to formula containing medium chain triglyceride (MCT) instead of long chain triglyceride which proved effective in stopping the diarrhea. We emphasis the importance of including the differential diagnosis of congenital obstruction in any baby with vomiting (especially bile stain vomiting) despite the fact that the baby had diarrhea and not constipation and the imaging studies were not obvious.