Original case by Eric Tanenbaum. Posts and edits by Brandon Fainstad, MD and Yilin Zhang, MD.
A 52 year old man with cerebral palsy, urinary retention and a one year history of intermittent, self-resolving abdominal pain, vomiting and an associated 15lb weight loss presents again with acute, severe abdominal pain with non-bloody emesis.
How would you interpret this CT?
Severely distended stomach extending into the scrotum through a left indirect inguinal hernia which also includes loops of the small bowel and sigmoid colon. Evidence of gastric outlet obstruction just proximal to the pylorus.