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Chika Edward Uzoigwe, MRCS; Krishna Bitra, MBBS; Kailas Munot, MD, MRCS; John P. Griffith, FRCS; Justin B. Davies, FRCS

Arch Surg. 2007;142(5):485.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

INTRODUCTION

A previously fit 24-year-old man presented with a 3-week history of colicky lower abdominal pain and constipation. His last bowel movement was 6 days prior to presentation. He had undergone an appendectomy 4 years previously. Laparotomy at that time had revealed a gangrenous perforated appendix.

On examination, the man was tender in the left iliac fossa with guarding. His abdomen was dull to percussion at the flanks and shifting dullness could be elicited. He had a pulse of 100 beats/min and a blood pressure of 100/70 mm Hg. Initial serological investigation showed marked leukophilia with a white blood cell count of 8300/µL. He was fluid resuscitated and underwent an emergent diagnostic laparotomy (Figure 1 and Figure 2).

Figure appears in full text version. Figure 1. Grossly dilated loops of the small bowel with fibrous adhesions . . . [Full Text of this Article]

What Is the Diagnosis?

Author Affiliations: Department of Surgery, Bradford Royal Infirmary, Bradford, England.

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Arch Surg. 2007;142(5):486.
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