Abstract
An 81-year-old man presented to a surgical take with a 4-day history of abdominal pain, distension and inability to open his bowels. Previous medical history included ischaemic heart disease, hypertension, atrial fibrillation and gout. On examination, the abdomen was distended with visible peristaltic bowel loops in the upper abdomen. It was soft and non-tender on palpation with tinkling (increased) bowel sounds on auscultation.
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