A 71 year old lady presented to the accident and emergency department with a two-day history of severe abdominal pain. She had not opened her bowel for 24 hours which was unusual for her. She had past medical history of nissen's fundoplication for hiatus hernia and gastro oesophageal reflux disease. Unfortunately, she was sent home with diagnosis of constipation. She returned ten hours later with worsening of abdominal pain. On examination, she was drowsy, pyrexial and tachycardic. Abdomen was distended, tender on palpation with severe guarding and rigidity.

Abdominal X-ray was performed after initial resuscitation.
What is the most likely diagnosis?



  1. Anonymous Says:
  2. intestinal obstruction

  3. EMDYX Says:
  4. messenteric infarction or trombosis....

  5. doctorsam Says:
  6. bowel obstruction.

  7. Anonymous Says:
  8. ileum of adhesions

  9. Anonymous Says:
  10. Paralitic ileum

  11. Anonymous Says:
  12. volvulous

  13. Anonymous Says:
  14. intestinal obstruction

  15. Anonymous Says:
  16. preforation and pretonitis

  17. Anonymous Says:
  18. coffee bean sing: Volvulus

  19. drbrender Says:
  20. Cecal Volvulus

  21. Anonymous Says:
  22. caecal volvulus- that history is suggestive of intestinal obstruction.(constipation, abdominal pain ). acute onset of symptoms and progression. radiograph shows that distended bowel part in the LUQ. two limbs of loop and flaterning of haustra are clearly seen.

  23. Anonymous Says:
  24. Sigmoid volvulus

  25. Anonymous Says:
  26. Perforation

  27. Anonymous Says:
  28. it can b perforation+obstruction and septicemia

  29. Anonymous Says:
  30. obstructed femoral hernia, as i can see the loop of bowel in the pelvis

  31. Anonymous Says:
  32. sigmoid volvolus

  33. I suffered from constipation for 4 years. Then I switched to veggies and fruits and I recovered from it.
    Triphala powder - It is a great laxative and helps to regulate digestion and bowel movements.

  34. That was very informative. Thank you very much for the share. Please update now and then.


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