Large bowel obstruction - malignant
Short history of increasing abdominal distension. 24 hours of failure to pass motions.
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Short stenosing stricture at the rectosigmoid junction.
Distended fluided filled large bowel most pronounced in the right side of the colon.
Large bowel obstruction is a key surgical pathology, one which both clinicians and radiologists working out of hours should be at capable of diagnosing and managing.
A high proportion are due to the first presentation of a sigmoid colorectal carcinoma. Complicated diverticular disease with stricture formation is another common cause.
This was a short stenosing rectosigmoid junction tumour causing a high grade large bowel obstruction. The right side of the colon is suggestive of imminent perforation.