Gross painless abdominal distension in an elderly patient
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Gross colonic dilatation from caecum to anus with no obstructing lesion identified - typical of this syndrome.
CT is helpful in delineating the cause of bowel dilatation. Always look for a point of transition from dilated to collapsed bowel = site of obstruction. In this case there is no transition point to the anus this mechanical obstruction is unlikely. On that basis this is likely to be a functional disorder of the bowel ie poor or absent peristalsis. Dilatation can be extreme even leading to venous ischaemia of the bowel wall and perforation.