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Man with severe abdominal pain

Abstract

Clinical introduction A 59-year-old man with no medical history presented to the ED with abdominal distension, vomiting and diffuse abdominal pain after drinking seven cups of white gourd drink (an authentic Asian drink composed mainly of white gourd). A chest radiograph was performed (figure 1).

Figure 1

Chest radiograph. AP, anteroposterior.

Question What is the most likely diagnosis?

  1. Crescent in doughnut sign, intussusception

  2. Falciform ligament sign, pneumoperitoneum

  3. Stepladder sign, small bowel obstruction

  4. Coffee-bean sign, sigmoid colon volvulus

  • abdomen
  • imaging
  • X-ray
  • resuscitation
  • clinical care

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