45 yr old male presented with c/o diffuse abdominal pain, vomiting bilious, obstipation for 3 days duration. P/A soft, BS heard P/R fecal staining present Blood investigations normal Xray findings and diagnosis??

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Gastric volvulus, advised emergency laprotomy.

Eventration Lt dome of Diaphragm. may b due to phrenic n palsy

Differentials - Gastric volvulus / diaphragmatic hernia

actually it's both!!!
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X ray shows eventration of left hemidiaphragm. With Per abdomen findings, pt is in obstruction, most likely gastric volvulus. Needs a ct abdomen With thorax Before surgery.

The fundus of stomach seen in lt.hemithorax with doubtful free gas under lt.dome of diaphragm.Strong suspicion of acute gastric volvulus.Advised urgent CT Abd.and then treat accordingly.

appears to be case of left diaphragmatic herniation with stomach (fundus ) as content.....may have pre- gangrenous changes but the vitals have not been mentioned..... my advice is CECT chest + abdomen followed by urgent laparotomy

chronic lung Abscess with encysted Pleural Effusion with fibrotic band in the Abscess surrounding parenchymal fibrotic band

No sir!!!
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xray gas under dome of diaphragm ? peptic perforation

peptic perforation ma free gas hoy... aa fundic gas che
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Diaphragmatic herniation with colonic volvulus and gastric volvulus

i like to do ultrasound of this pt , xray is not suggestive of aanythng n hv to see clinically also.....

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Diseases Related to Discussion

Diaphragmatic Hernia
Hernia
Volvulus
Constipation
Lung Abscess

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