Figure 4.

Large bowel obstruction secondary to diverticular stricture. Plain radiographs of the abdomen, supine and erect views (a and b) in a 45-year-old man presenting to the emergency department with severe abdominal pain and lack of bowel movements demonstrate markedly dilated loops of large bowel compatible with large bowel obstruction. Axial (c) and coronal (d) contrast-enhanced computed tomography images demonstrate dilated large bowel loops (arrow in c) with associated concentric thickening and stricture (arrow in d) of the distal descending colon without discrete mass. Single column barium enema (e) performed subsequently better demonstrates the stricture (short arrow) and an additional fistula (long arrow). Axial computed tomography image (f) performed an year earlier demonstrates changes of acute diverticulitis which eventually led to stricture and large bowel obstruction.