Admitted with pyonephrosis of a non functioning left kidney. Developed a distended abdomen during admission.
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Left nephrostomy tube. Dilated featureless loop of bowel in the central abdomen. Small bowel dilatation. Gas in the ascending colon.
The large loop of dilated bowel in the central abdomen is the volved caecum, with a resultant small bowel obstruction.
This film is made more challenging by the gas retained in the semi-dilated ascending colon.
At surgery a caecal volvulus was identified and surgically corrected.