Wow! I am beat! After a month of quiet ward, my ward is suddenly packed with complicated problems. Am I complaining, well not really!

I was on call yesterday and as usual the call was eventful. To summarise, it was exciting especially for this three cases.

The first, was an on table referral from the obstetric team. This was about a pregnant lady who was at term with her pregnancy and suddenly presented to us for very severe abdominal pain. An emergency surgery was performed to deliver the big baby of 4kg. Surprisingly, her abdomen was completely normal except for this:

A common presentation in pregnant women. Her abdominal pain was caused by blocks or clusters of hard stools impacting her large intestine. Almost two thirds of her large bowel were packed and clustered with these hard stools.

Advice, please to all pregnant women, drink plenty of fluids, eat lots of fibres and if constipated get some laxatives.

Next, was a young lady in her teens who was involved in a road transport accident and this was her CTscan findings.( not clear – sorry!)

She had shattered her left kidney but luckily, she was very stable. Her case was taken over by the urology team.

The last but not least, this elderly lady presented with an bowel obstruction and had a large tense right lower abdomen mass. Her scans are as below. Care to make a guess?

Care to guess the last scans?