Perforated, malignant large bowel obstruction due to cecal distension and venous ischemia
Diagnosis almost certain
Presentation
Abdominal pain and distension. Nil passage of flatus, ? bowel obstruction
Patient Data
Age: 90 years
Gender: Male
Patient unwell no IV/oral C+
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Distension of the colon to the sigmoid with abrupt transition to collapsed rectum. Irregular mass in the sigmoid is probably cancer although a diverticular stricture is possible. Gross cecal dilatation with swollen irregular, gas-filled mucosa is compatible with ischemia (probably venous due to luminal distension) and free gas indicating perforation, although the site of perforation is not identified.