Thanks to those of you who posted comments or sent emails suggesting a solution... it seems that my clues were too cryptic!Here is the clue again but with highlights...
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Some need a clue to the diagnosis in this case for a bolus point:
A scar is the solution, it all comes to the helm in the end!
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The answer is that the child had sub-acute obstruction caused by a bolus of ascaris roundworms, a type of helminth parasite infection. Ascaris are quite common but usually only cause mild problems such as malabsorption with the risk of compromise of the child's nutrition.
This unfortunate child had hundreds of worms which were vomited or passed once we gave the child anti-helminth medication [mebendazole].
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