A 78-year-old woman presented with nausea, vomiting, crampy abdominal pain and distention. She had had a sigmoid carcinoma (T3, N1, M0) six years previously and a left hepatic resection for metastasis 18 months previously.
Because the patient had localized lower abdominal tenderness she underwent immediate laparotomy. A closed loop obstruction with compromised bowel was found distal to dilated small bowel. There was no evidence of recurrent carcinoma.
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