No abstract available.

A 30-year-old man was referred from a peripheral hospital with a 6-day history of abdominal pain and vomiting. He had been constipated for the previous 3 weeks. He was acutely ill and de hydrated. His pulse rate was 102/min, blood pressure (BP) 115/65 mmHg, respiratory rate 20/min and temperature 37.9 ºC.Abdominal examination revealed a distended stomach with a succussion splash. There was no rebound tenderness and rectal examination revealed stools in the rectum. A provisional diagnosis of a gastric outlet obstruction was made and a nasogastric tube was inserted draining green gastric contents.An abdominal X-ray was rather nonspecific showing a single dilated loop of small bowel with some fluid levels in the right upper quadrant and stools and air in the rectum.Serum electrolytes and full blood count (FBC) were compatible with dehydration and vomiting, with urea 30.2 mmol/l, potassium 2.5 mmol/l, and sodium 130 mmol/l. The white cell count was 11.5 x 10 9 /l. Endoscopic examination showed a normal oesophagus and stomach

No abstract available.

No abstract available.

No abstract available.