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A 39-year-old woman with a previous diagnosis of irritable bowel syndrome presented with progressively worsening episodes of marked abdominal distension and difficulties with defecation. She had a long history of constipation and had tried a variety of laxatives with an unsatisfactory response. Recent colonoscopy was unremarkable. Physical exam revealed a protuberant abdomen with tympany and high-pitched bowel sounds. Inspection of the anus …
Competing interests None.
Patient consent Obtained.
Ethics approval This study was conducted with the approval of the Mayo Clinic College of Medicine. Institutional review board approval is not required for single case reports.
Provenance and peer review Not commissioned; internally peer reviewed.