Psychotic Woman With Painful Abdominal Distension

Chest radiograph showing an enormous gaseous dilation of the stomach and the large bowel.

CT of the abdomen showing the hepatodiaphragmatic interposition of the large bowel (Chilaiditi sign).

Acute colonic pseudo-obstruction with massive distension of the whole bowel.

Typical bluish aspect of the infarcted intestinal loops that had to be removed during the open surgical procedure. Used with permission of Malcolm Lemyze, MD, Department of Emergency and Critical Care Medicine, Broussais Hospital, St Malo, France.