TY - JOUR T1 - Not so fun at the funfair… JF - Archives of disease in childhood - Education & practice edition JO - Arch Dis Child Educ Pract Ed DO - 10.1136/archdischild-2021-323136 SP - edpract-2021-323136 AU - Diarmuid McLaughlin AU - Martin Hanna AU - Patrice Eastwood AU - Peter Mallett AU - Andrew Thompson Y1 - 2022/08/08 UR - http://ep.bmj.com/content/early/2022/08/08/archdischild-2021-323136.abstract N2 - A 1-year-old girl presented with a 3-day history of non-bilious vomiting, reduced intake and lethargy. Her last bowel movement was 4 days prior. She was previously well with no ill contacts or foreign travel. On examination, she was tachycardic with a prolonged capillary refill time. Her abdomen was soft, not distended with no palpable masses. Blood tests including full blood count, renal and C reactive protein (CRP) were normal. She initially received supportive treatment with intravenous fluids and analgesia. On day 4 of admission, an abdominal X-ray (AXR) was performed due to persistent vomiting (figure 1).Figure 1 Abdominal X-ray demonstrating dilated small bowel loop in left lower quadrant.What is the most likely diagnosis?Acute infective gastritisIntestinal malrotationSevere constipationSmall bowel obstructionShe became progressively more unwell. A further detailed history revealed the family had recently returned from a family trip to the funfair. Pale green, bilious vomiting was observed and examination revealed abdominal distension with no overt signs of … ER -