An ileocecal interposition (ICI) between the descending colon and anus was performed in a girl, 14 months old, with congenital aganglionosis up to the sigmoid colon. The left colon could not safely be mobilised because the paracolic arcade had been interupted during a preceding colostomy construction. The functional result, 14 years after reconstruction, is excellent: 1-2 easy defecations per day with normal continence for flatus and stool. An ICI may be an appropriate rescue procedure, saving a maximum length of normally innervated bowel and providing a neorecta1 reservoir.