case_images: PMC3226425_01
case_images: 7 mm obstructing left PUJ calculus.
case_images: CRIM2011-145084.001.jpg
case_images: PMC3226425_01_CRIM2011-145084.001.jpg
case_images: fig1
case_images: An urgent ultrasound showed left-sided hydronephrosis with an obstructing 7 mm calculus (Figure 1) and large amounts of free peritoneal fluid.
case_images: Free peritoneal fluid.
case_images: CRIM2011-145084.002.jpg
case_images: PMC3226425_01_CRIM2011-145084.002.jpg
case_images: fig2
case_images: CT of the abdomen without contrast confirmed the presence of extensive free fluid (Figure 2), predominantly along the paracolic gutters and extending under the hemidiaphragms with "scalloping" of the liver.
case_images: Distended sigmoid colon.
case_images: CRIM2011-145084.003.jpg
case_images: PMC3226425_01_CRIM2011-145084.003.jpg
case_images: fig3
case_images: The sigmoid colon was markedly distended (Figure 3) with faeces lifting it out of the pelvis to the level of L2. Intraoperatively a distended sigmoid colon predominantly occupied the true pelvis (Figure 3), but there was no evidence of bowel ischaemia.