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Picture quiz: Cochlear bowel

BMJ 2002; 324 doi: (Published 01 February 2002) Cite this as: BMJ 2002;324:020211
  1. Vibhore Gupta1,
  2. D Sunderamoorthy1
  1. 1Birmingham Heartlands Hospital, Birmingham B9 5SS

Case history

A 72 year old man presented at the accident and emergency department with a one day history of diffuse colicky abdominal pain associated with abdominal distension and constipation. There was no associated vomiting. Abdominal examination revealed generalised distension without peritonism and increased bowel sounds. There was an operative scar in the right groin from a previous inguinal herniorraphy. The figure shows the abdominal x ray film.


  • (1) What is your diagnosis ?

  • (2) How would you …

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