Anatomy clinical correlates Quiz: Ace Your Exams

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A 70-year-old man comes to the emergency department because of abdominal distension. The patient has had abdominal pain, nausea, and decreased appetite associated with progressive abdominal distension for the past three days. His last bowel movement was five days ago. The rest of the review of systems is unremarkable. Past medical history is significant for chronic constipation, hypertension, type II diabetes mellitus, and hypercholesterolemia. The patient had an open cholecystectomy several years ago. Temperature is 37.6°C (99.8°F), pulse is 90/min, respirations are 18/min, and blood pressure is 140/70 mmHg. Physical examination shows a distended and tympanitic abdomen with diffuse tenderness to palpation, but no rigidity, rebound tenderness, or guarding. A supine abdominal x-ray is shown below. Which pathophysiological process most likely contributed to this patient’s condition?  


A full body, frontal X-ray image of human torso, revealing skeletal structure & large, dark intestinal loops indicating significant gas distention.
Reproduced from Radiopedia

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