ABSTRACT
A A 62-year-old man presents with generalised colicky abdominal pain with bilious vomiting for 48 hours. His symptoms have been intermittent. He has a distended abdomen with generalised tenderness without any rigidity or rebound tenderness. Following an operation for left hemicolectomy 3 years ago through a long midline incision, he has had several such episodes some of them requiring admission.
