Case 154

Medical history

A 68-year-old female patient attends to the emergency room complaining of abdominal pain and distension in the past 24 hours, together with multiple vomit episodes. At physical exam, is sudoretic, regular BP, distended abdomen, increased peristalsis, diffuse abdominal pain, but without apparent peritoneal irritation. Refers intestinal constipation, with the last bowel movement in 48 hours. In the past year, had multiple episodes of abdominal colicky pain, less intense than present, with spontaneous resolution. A computerized tomography was made.

Based on the clinical picture and the CT findings, which of the following is the most likely diagnosis?

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