Article Text

Download PDFPDF
Man with severe abdominal pain


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

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.