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Emerg Med J doi:10.1136/emermed-2012-202075
  • Images in emergency medicine

Distal intestinal obstruction syndrome: a mimic of acute appendicitis

  1. Sree Harsha Tirumani2
  1. 1SVS Medical College, Mahabubnagar, India
  2. 2Department of Imaging, Dana Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts, USA
  1. Correspondence to Dr Sree Harsha Tirumani, Department of Imaging, Dana Farber Cancer Institute, Harvard Medical School, 450 Brookline Ave, Boston, MA 02215, USA; tirumani.sreeharsha{at}gmail.com
  • Received 15 October 2012
  • Revised 9 December 2012
  • Accepted 24 December 2012
  • Published Online First 23 January 2013

A 23-year-old female with a history of cystic fibrosis (CF) presented to the emergency room with abdominal pain (7/10), vomiting and constipation for 3 days. Clinical examination revealed severe dehydration and distended tympanitic abdomen with palpable tender right lower quadrant lump. Laboratory examination revealed leukocytosis, anaemia and metabolic acidosis. Plain abdominal radiograph revealed small …