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Abdominal pain following obesity treatment
  1. Kamal V Patel1,
  2. Joanne Ooi1,
  3. Shuvra Ray1,
  4. Nyree Griffin2,
  5. Jude A Oben1
  1. 1Department of Gastroenterology, Guy's and St Thomas’ NHS Foundation Trust, London, UK
  2. 2Department of Radiology, Guy's and St Thomas’ NHS Foundation Trust, London, UK
  1. Correspondence to Dr Jude A Oben, Department of Gastroenterology, First Floor College House, St Thomas’ Hospital, Westminster Bridge Road, London SE1 7EH, UK; jude.oben{at}gstt.nhs.uk

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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).

Figure 1

Emergency abdominal x-ray.

Question

What is the diagnosis and next management step?

Answer

CT findings (figures 2 and 3) were reported …

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