nuh.com.sg Clinics in diagnostic imaging (105)

An 89-year-old woman with multiple comorbidities was initially being evaluated for chronic constipation. During bowel preparation with polyethylene glycol (Fortranf®, Sime Darby Marketing, Singapore), she started vomiting, and complained of abdominal pain. Physical examination showed a distended CME Article Fig. 1 Abdominal radiograph obtained on admission. abdomen and hyperactive bowel sounds. Abdominal radiograph was obtained (Fig. 1). A procedure was then performed and a repeat radiograph was done a day later (Fig. 2). She was able to eat and pass motion immediately post-procedure, and was discharged two days later. What is the initial diagnosis? What procedure was performed? Fig. 2 Abdominal radiograph obtained one day after the procedure