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 tumor causing a high grade large bowel obstruction. The right side of the colon is suggestive of imminent perforation.