Intended for healthcare professionals

Endgames Spot Diagnosis

A woman with abdominal distension and pain

BMJ 2016; 352 doi: (Published 22 March 2016) Cite this as: BMJ 2016;352:i1382
  1. Joseph Dalby Sinnott, core surgical trainee1,
  2. David C Howlett, consultant radiologist2
  1. 1 Eastbourne, ESHT, Eastbourne, UK2 Department of Radiology, East Sussex Hospitals NHS Trust, Eastbourne, UK
  1. Correspondence to: J D Sinnott j.d.sinnott{at}

A 40 year old woman presented to the surgical assessment unit with a 12 hour history of abdominal distension and tenderness. She had not opened her bowels or passed wind since her symptoms started. An abdominal radiograph was requested—what does it show (fig 1)?


The abdominal radiograph shows a caecal volvulus.


Caecal volvulus is much less common …

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