Large bowel obstruction
What is the most common cause of large bowel obstruction in adults in Australia?
Colorectal carcinoma makes up about 50-60% of large bowel obstructions.
This patient has a sigmoid volvulus. What sign does the x-ray show?
The appearance is due to the closed loop obstruction in a sigmoid volvulus. All of the answers seem possible but coffee bean is correct--not sure if it is Arabica or Robusta.
This patient has a rather unusual cause of a large obstruction in an adult. It is usually seen in children. What does the x-ray show?
Intussusception does occur in adults but is rare. This is a colonic/colonic rather than an ileocolic variant.
Pseudo-obstruction of the large bowel is known by what name?
Ogilvie syndrome was first described in 1948. Most commonly seen in elderly bed bound patients. There is malfunction of autonomic control. Note---the arrow in the x-ray is pointing to a rectal tube.
In 2019 Pat Sajak developed a large bowel obstruction. He is the longest running host of a game show. What is that game show?
The Price is Right is the longest running game show but does not have the longest running host. Pat Sajak has been hosting Wheel of Fortune since 1981. He apparently gets US$15 million per year. No wonder he looks happy in the photo.
This gentleman has a large bowel obstruction. What is the cause of the large bowel obstruction?
You can see the large bowel in the hernia.
This elderly lady has a distended tender abdomen from the large bowel obstruction. What is the etiology?
It is the characteristic finding of a caecal volvulus with the twisted distended caecum in the left upper quadrant. Note---I made up the transverse colon volvulus.
This CT cut is of a patient with a sigmoid volvulus. The arrow points to where the mesentry with its vessels are twisted. What is the name of this appearance?
It is from torsion of the sigmoid mesentry and is also known as the whirlpool sign. Note the phrase is also used in other conditions where there is twisting of the mesentry or vascular pedicle like in small bowel obstructions or ovarian torsion.
What is this doctor decompressing?
He is using a rectal tube to decompress a sigmoid volvulus.
In what country is the earliest recording, in the medical record, of the use of enemas?
Earliest mention in the medical literature was made in ancient Egypt, in the Ebers Papyrus, in 1550 BC. Apparently according to Egyptian mythology the god Troth invented the enema. For those interested in the world of enemas google ---John Harvey Kellogg---you will never look at your cornflakes the same way again.