12 year old male with history of patent ductus arteriosus presents to the Emergency Department for evaluation of acute diffuse abdominal pain for the last x5 days. Patient has had vomiting for this timeframe and has not had a bowel movement in x6 days. Diagnosis?

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Doges cap sign (free air in Morrison's pouch) Pnemoperitonium.

Pneumoperitonium...

?intestinal obstruction

Intestinal Obstruction.

Large bowel volvulous .or recto sigmoid obstruction ?cause ct. Abd.

Sub acute intestinal obstruction

Intestinal obstruction ,need barium follow through.

Intucecception dd volvulus

Gaseous intestinal distension.most probably obstruction.

?intestinal obstruction

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