drabuaiad

### Case Summary

29 y old male

- History of massive accident 4 years ago leading to lower limb paralysis
- No urine or stool control
- No sensation

- Developed progressive constipation 3 days ago
- X-ray erect shows gasless abdomen; stomach is massively dilated with fluid level

- Ultrasound shows markedly dilated fluid-filled stomach and small bowels; no free fluid; no peristalsis

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