5 days old male Newborn, admitted to emergency department with complain of no evacuation since birth. The physical examination reveal distended abdomen, hypertympanic, palpable bowel and noise reduction on the left. Was conducted a radiography of abdomen and a contrast enema (see images). The patient was submitted to the emergency laparotomy, with the perioperative finding of megacolon (sigmoid) with transition zone in the rectosigmoid region.