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Abdominal distension
  1. A Mukhtar,
  2. N Sundar,
  3. I A Finnie
  1. Department of Gastroenterology, Glan Clwyd Hospital, Bodelwyddan, Denbighshire LL18 5UJ, UK
  1. Correspondence to:
 Dr Finnie;
 Jo.Barlow{at}cd-tr.wales.nhs.uk

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Answers on p 435.

An 87 year old woman presented with a two month history of abdominal distension and vomiting. Previous investigations for iron deficiency anaemia had been normal. There was no recent change in bowel habit. On examination she was afebrile. The abdomen was soft, distended, with no tenderness or guarding and the bowel sounds were normal. A detail from the plain abdominal radiograph is shown (fig 1), together with a representative film from a subsequent investigation (fig 2).

Figure 1

Plain abdominal radiograph.

Figure 2

Film from a subsequent investigation.

QUESTIONS

  1. What does the plain abdominal radiograph (fig 1) show? What was the subsequent investigation (fig 2) and what does this show?

  2. How would you manage this patient?

  3. What mechanism results in the development of the radiological abnormality shown in fig 1?

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