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A 61-year-old woman presented to the emergency department with a 3-day history of vomiting, abdominal distension and pain plus anorexia. This was on a background of morbid obesity, non-alcoholic fatty liver disease and previous laparoscopic cholecystectomy. An elective procedure to enhance weight loss had been performed 5 months before the acute admission, without complication before presentation.
On examination her abdomen was soft, tender and with a palpable epigastric mass. Blood tests and vital signs were unremarkable. Chest radiography revealed no subdiaphragmatic free air but abdominal radiography revealed a significant abnormality (figure 1).
What is the diagnosis and next management step?
CT findings (figures 2 and 3) were reported …