TY - JOUR T1 - Constipation, failure to thrive and recurrent abscesses: getting to the bottom of an unusual complaint JF - Archives of disease in childhood - Education & practice edition JO - Arch Dis Child Educ Pract Ed SP - 306 LP - 308 DO - 10.1136/archdischild-2018-315317 VL - 104 IS - 6 AU - Peter Mallett AU - Caroline Hart AU - Josip Marjanovic AU - Damian Maguire AU - Majella McCullagh AU - Andrew Thompson Y1 - 2019/12/01 UR - http://ep.bmj.com/content/104/6/306.abstract N2 - A female infant was born in good condition at term. Meconium was passed within the first 48 hours of life. At 3 weeks of age, she presented with constipation and a presumed isolated buttock abscess requiring drainage. Inspection of the perianal area was felt to be normal. A large volume of pus was drained and she was discharged home on oral antibiotics.Which procedure may have been most appropriate to offer an initial clue to her diagnosis? Abdominal X-ray. Digital rectal examination. Perianal swab for streptococcal infection. Sweat test. Ultrasound scan of the abdomen.At 6 months of age, she presented with a second abscess, constipation and poor weight gain.What is the most likely diagnosis? Congenital anorectal anomaly. Cow’s milk protein allergy. Hirschsprung’s disease. Immunodeficiency disorder. Infantile perianal Crohn’s disease.Poor weight gain persisted and she re-presented acutely unwell at 9 months of age with a ruptured perianal abscess. Given these recurrent abscesses, with … ER -