Case 307

Medical history

A seven years old boy presented in a Emergency Service with complaints of diffuse abdominal pain and bilious vomiting, since 2 days, and absence of defecation since 6 days. History of constipated bowel habit and appendectomy performed 6 months ago. On physical examination, he had a distended abdomen. Clister with saline solution was performed during the treatment, with no stool output. Rectal examination showed no blood. Simple abdominal radiographs were requested (Images 1 and 2).

Given the clinical history and the patient's images, what is the most likely diagnosis?

Test question

(UFF-2014) What signs and symptoms MORE suggest an acute obstructive abdomen?

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