Medical history A 44-year-old man presents with a 15-day history of severe lower abdominal pain, nausea, vomiting, and obstipation associated with diarrhea. Loss of 15kg in the last months. No previous surgeries. Physical examination showed: pallor, distended abdomen, painful palpation of the lower abdomen, no masses or signals of peritonitis. Abdominal and chest radiographs and computed tomography of the abdomen and pelvis were requested. Abdominal radiograph, anteroposterior (A) supine and (B) erect views.Chest radiograph, posteroanterior view.Intravenous contrast-enhanced axial computed tomography (CT) of the pelvis, section level of the bladder, portal venous phase.Intravenous contrast-enhanced CT of the abdomen and pelvis, coronal reconstruction, portal venous phase. Question:Considering the clinical presentation, the initial hypothesis of partial intestinal obstruction, and the images presented, what is the most likely diagnosis? Adhesive intestinal obstruction Crohn's disease Colorectal cancer Sigmoid volvulus Test question [UFPR Residency Exam - General Surgery, 2009] Regarding large bowel obstruction, what is the INCORRECT answer? Malignant neoplasm is the most common cause Cecum is the location of highest perforation rate The most common location of volvulus is the sigmoid, followed by the cecum The diagnosis of large bowel obstruction is mainly based on clinical presentation and abdominal radiograph Ogilvie syndrome is a sequel to post-diverticulitis fibrosis Time is Up! Time's up
