Editor's quiz
A tenacious complete small bowel obstruction
1 Emergency Surgery and Trauma Surgery Unit, Trauma Center, Department of Emergency, Department of Surgery, Maggiore Hospital, Bologna, Italy
2 Emergency Surgery Unit, Department of General and Transplant Surgery, S Orsola Malpighi University Hospital, Bologna, Italy
Correspondence to:
Dr S Di Saverio, Emergency Surgery and Trauma Surgery Unit, Maggiore Hospital, Bologna Local Health District, Logo Nigrisoli 2, 40100 Bologna, Italy; salo75@inwind.it
| The first 100% of the full text of this article appears below. |
CLINICAL PRESENTATION
A 41-year-old man presented to the Emergency Department complaining of abdominal distension associated with a vague pain for a few days previously and sudden onset 12 h earlier of cramp-like worsening abdominal pain, localised in the lower quadrants, associated with increasing nausea. The patient was previously healthy except for peptic ulcer treated with oral proton pump inhibitors, and previous appendectomy in his youth. The laboratory results showed neutrophil leucocytosis (white blood cell count 13 990). Plain abdominal x xay performed in the morning did not show significant air-fluid levels or free air. In a few hours, the pain worsened and an urgent CT scan was ordered (fig 1).
Figure 1 Abdominal CT scan.
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QUESTION
What is the diagnosis?
See page 891 for the answer.
This case is submitted by:
Robin Spiller, editor
Competing interests: None.
Patient consent: Obtained.
Institution:
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ANSWER
Gut 2009 58: 891-892.[Extract] [Full Text] [PDF]
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