2. Particulars of the
patient
Name : Kowshik alom
Age : 2 years
Sex: Male
Religion : Islam
Address : Barhatta , netrokona
Date of admission : 24/11/2022
Date of examination : 24/11/2022
4. History of present
illness
According to statement of informant
mother , presenting complaint started
since birth . The child did not pass
meconium up to 3 days after birth and then
passed meconium with the assistance of
suppositories . Since then child defecates
infrequently at 3-4 days interval with the
help of suppositories , laxatives and
sometimes spontaneously . Mother also
complaints of gradual abdominal
distention since then which was
accelerated in last 2 months.
5. Contd….
There are also complaints of occasional
non bilious projectile vomiting . For these
complaints he was taken to local doctors
and took antiemetic and laxatives in last 2
years for several times . There are no
history of fever , diarrhea , blood
mixed stool or perineal soiling . As of no
improvement of the condition the parents
admitted their child in department of
pediatric surgery of mymensingh medical
college hospital.
7. Birth history
Antenatal history : uneventful but the
mother was not on regular checkup and
was not on anti thyroid drugs .
Natal history : He was delivered by NVD
at term at home .
Post natal history : uneventful except
delayed passage of meconium
8. Feeding history : The child was on exclusive
breast feeding and now on family diet .
Developmental history : His milestone of
development are normal .
Immunization history : Immunized as per
EPI schedule
Treatment history : Treated by laxatives and
suppositories .
9. Family history
The baby was 3rd issue of non
consanguineous parents . Parents and
other siblings are good health . No
family history of same type of illness .
11. General
examination
Appearance : well alert
Anemia : mild
Jaundice : absent
Edema : absent
Cyanosis : absent
Clubbing : absent
Koilonychia : absent
Lymph node : No accessible lymph node are found
Temperature : normal
Pulse 100 beat /min
Res rate : 24B/MIN
12. Systemic
examination (GIT)
Mouth and oral cavity : healthy
Abdomen :
Inspection : Abdomen was distended ,
umbilicus centrally placed and inverted , no
visible peristalsis , no engorged vein or
scar mark . Hernial orifice were intact .
Palpation : Abdomen was soft and non
tender, no organomegaly , fecoloma or
ascities were present
13. Systemic
examination (
contd.)
Percussion : Tympanic , shifting dullness
absent
Auscultation : Bowel sound present .
Perineal examination : No perineal soiling ,
anus is normally placed , no excoriation or
fissure is noted .
D/R/E : Rectal grip can be felt on inserted
finger and index finger is snugly fitted to
the rectum . Rectum was empty . After
withdrawal of finger a gush of flatus and
feces comes out .
15. Salient feature Kowshik alom , a 2 years old boy hailing
from barhatta ,netrokona , got admitted with
the complaints of chronic constipation
since birth , gradual abdominal distention
and occasional vomiting for same duration .
The child did not pass meconium up to 3
days after birth and then passed meconium
with the assistance of suppositories . Since
then the child defecates infrequently at 3-4
days interval with the help of suppositories
, laxatives and sometimes spontaneously .
16. Contd.... Patients also complaints of gradual
abdominal distention since then which was
accelerated in last 2 month . There are also
complaints of occasional non projectile
bilious vomiting . For these complaints he
was taken to local physician and took
antiemetic , laxatives and suppositories in
last 2 years for several times . There are no
history of fever , diarrhea , blood mixed
stool or perineal soiling . His general survey
is essentially normal except mild anemia.
17. Contd..... Abdomen is distended , umbilicus is
centrally placed no visible peristalsis ,
organomegaly fecaloma or ascites .bowel
sound is present . There is no perineal
soiling , anus is normally placed . No
excoriation or fissure is noted , index finger
is snugly fitted to the rectum . Rectum was
empty . After withdrawal of finger a gush of
flatus and feces comes out . Other systemic
examination reveals normal .
