Picture Quiz: Cochlear bowel
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 herniorrhaphy. Figure 1 shows the abdominal x ray film.