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Rare Cause, Common Presentation!

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Author: Mohamed Nasreddin / Editor: Emily Rashleigh / Codes: SLO3, SuC11, SuC4, SuP1, SuP3Published: 22/05/2026

A 72-year-old woman with diabetes mellitus (DM) and hypertension (HTN) and no prior surgical history, presents with an 8-day history of progressively worsening abdominal pain, distension, absolute constipation and vomiting. She also reports anorexia and weight loss over the past few months.

Examination reveals a cachectic patient with the following vital signs: HR 105 bpm, BP 110/64 mmHg, Temp 37.6°C, RR 20 bpm, and Spo2 on RA 93% with a distended but soft abdomen.

A plain X-ray abdomen was initially done (Image 1), VBG showed mild lactic acidosis, while other routine lab results were acceptable.

Image 1 – Patient x-ray (Courtesy of the author)

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Rare Cause, Common Presentation!

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