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Figure 1. A 54-year-old woman with lung cancer presented with severe abdominal pain and bilious vomiting. She had had a diagnostic barium small-bowel follow-through 10 days earlier for nausea and vomiting. She had undergone a partial left lobectomy in 1987 and 1992 and a Billroth II gastric resection many years earlier for peptic ulcer disease. On examination she was dehydrated and had diffuse abdominal tenderness but no peritoneal signs. Abdominal plain films showed inspissated barium (arrows in Panels A and B) in the sigmoid colon. Efforts to break up the impaction manually failed. Flexible sigmoidoscopy was attempted, but a . . . [Full Text of this Article]
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