A 60-year-old man presented with generalized abdominal pain, bloating, constipation and nausea. Examination revealed a tender, distended abdomen, but peritonism was not present. Bowel sounds were absent. The patient was afebrile. Haematological and biochemical parameters, including lactate, were within normal limits. Neither abdominal X-ray nor computed tomography scan demonstrated bowel obstruction. He had previously had several similar presentations.
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