A man in his seventies presented with abdomen pain for 1 day. He had diabetes, hypertension and right hemicolectomy performed around 20 years ago from colonoic perforation. The pain was associated with nausea and vomiting.
Vitals: BP 160/85mmHg, T 36.5, HR 103, RR 21 and SpO2 100% on room air. There was generalized abdominal tenderness. The per rectal examination revealed an empty rectum.
Given the history of right hemicolectomy, an AXR was ordered to exclude intestinal obstruction.
DId you see the intestinal obstruction on this plain film?