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Case 97: Abdominal distension and vomiting

A 43 year old man presents with central coloicky abdominal pain, distension and vomiting. He has a history of appendicectomy but no other abdominal operations. A radiologic study is shown below.

1. What is the study and diagnosis?

2. What is the potential role of this study in the management of this man?

3. If conservative management is successful what other options would you consider in future?