Man with severe abdominal pain.

CLINICAL

INTRODUCTION

A 59-year-old man with no medical history presented to the ED with abdominal distension, vomiting and diffuse abdominal pain after drinking seven cups of white gourd drink (an authentic Asian drink composed mainly of white gourd). A chest radiograph was performed (figure 1).emermed;35/9/571/F1F1F1Figure 1Chest radiograph. AP, anteroposterior.

QUESTION: What is the most likely diagnosis?Crescent in doughnut sign, intussusceptionFalciform ligament sign, pneumoperitoneumStepladder sign, small bowel obstructionCoffee-bean sign, sigmoid colon volvulus.