case_images: PMC5390630_01
case_images: Abdominal X-ray showing scattered air-fluid levels in minimally prominent small bowel loops (case  1).
case_images: CRIM2017-5982910.001.jpg
case_images: PMC5390630_01_CRIM2017-5982910.001.jpg
case_images: fig1
case_images: Scattered air-fluid levels indicating small bowel obstruction were seen on erect abdominal X-ray (Figure 1).
case_images: Dilated multiple loops of proximal small bowel with collapsed distal loops of small bowel consistent with small bowel obstruction (case  1).
case_images: CRIM2017-5982910.002.jpg
case_images: PMC5390630_01_CRIM2017-5982910.002.jpg
case_images: fig2
case_images: Computer tomography confirmed the diagnosis (Figure 2).
case_images: ST elevation in inferior and lateral leads (case  1).
case_images: CRIM2017-5982910.003.jpg
case_images: PMC5390630_01_CRIM2017-5982910.003.jpg
case_images: fig3
case_images: To our surprise, the ECG showed sinus tachycardia with inferolateral ST elevation (Figure 3).
case_images: Resolution of ST elevation in inferolateral leads after surgical decompression (case  1).
case_images: CRIM2017-5982910.004.jpg
case_images: PMC5390630_01_CRIM2017-5982910.004.jpg
case_images: fig4
case_images: Soon after laparotomy and resolution of obstruction, the dramatic ECG changes disappeared (Figure 4) while the cardiac biomarkers remained negative making an acute coronary event unlikely.
case_images: PMC5390630_02
case_images: ST elevations in leads II, III, aVF, V5, and V6 (case  2).
case_images: CRIM2017-5982910.005.jpg
case_images: PMC5390630_02_CRIM2017-5982910.005.jpg
case_images: fig5
case_images: However, in the emergency room, ECG demonstrated ST elevations in leads II, III, aVF, V5, and V6 (Figure 5).
case_images: Coronary angiography showing no obstructive coronary artery lesions responsible for ST elevation (case  2).
case_images: CRIM2017-5982910.006.jpg
case_images: PMC5390630_02_CRIM2017-5982910.006.jpg
case_images: fig6
case_images: This revealed no angiographic evidence for obstructive coronary artery disease (Figure 6) but an abnormal left ventricular systolic function with ejection fraction around 35%.
case_images: Resolution of ST elevation after surgical intervention (case  2).
case_images: CRIM2017-5982910.007.jpg
case_images: PMC5390630_02_CRIM2017-5982910.007.jpg
case_images: fig7
case_images: Repeat ECG immediately after the surgical procedure revealed resolution of ST elevation in inferior and lateral leads (Figure 7).