ABSTRACT
History A 72-year-old woman presented to the surgical assessment unit (SAU) with abdominal pain, distension, and constipation for the past week. She reports having not felt well for the past few months, with progressive tiredness and shortness of breath when walking up the hill to her local shops. She has become anorexic, has been unable to open her bowels for the past week and has been suffering from worsening constipation for a couple of months, despite taking senna and lactulose prescribed by her GP. Over the past couple of days, her abdomen has become distended and painful.
