Case 157

Case 157


An 86 year-old male patient, born at Carmesia-MG Brazil, attends to the emergency room complaining of severe periumbilical pain, worsening in the past hours. Refers nausea, no vomiting. Stated to be constipated in the past 10 years and the lost of 5kg in the last year. On physical examination: oriented, afebrile, normal respiratory rate; distended abdomen, with increased peristalsis, diffusely painful and the presence of a fecaloma at the rectal exam.

Image 1: Anteroposterior abdominal radiography, with patient in dorsal decubitus.

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