mid-60s, presents with abdominal pain, no vomiting, last bow | Figure 1

forderit

Emergency Medicine

mid-60s, presents with abdominal pain, no vomiting, last bowel opening two days previously, figures 1 and 2 show prominent bowel loop but no air/fluid levels. The patient has a good bowel motion with enema. Subsequent laxatives given, but patient starts vomiting. CT performed on 2nd presentation. Herniation of a loop of mid small bowel through the defect into the anterior mediastinum was noted.

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