Image of the Week: What is causing this child’s lethargy and foul-smelling vomiting?

A 7-year-old girl presents with subacute lethargy, abdominal pain and distension, and foul-smelling vomiting in the context of a lifelong history of chronic constipation and delayed growth. She has not seen a doctor in years because her family lives in a remote, under-resourced area. An X-ray reveals a fecaloma in the large bowel. Learn more about this case, take the quiz, and join the conversation on Figure 1.

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