This 55-year-old hypertensive woman had a suboccipi-tal craniectomy for cerebellar haematoma. Post-operative recovery was uneventful except for pneumonia. One month later, she developed acute abdominal pain without vomiting. Physical examination revealed distended tender abdomen and decreased bowel sounds. Blood investigations were unremarkable except for severe hypokalaemia (1.5mmol/L). Plain radiography (Fig. 1a) and abdominal CT-scan (Fig. 1b) showed markedly dilation of whole colon without mechanical obstruction. Treatment was initiated symptoms rapidly resolved.
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