31st July 2023

A 75-year-old male with a background of Parkinson’s disease is brought to A&E

A 75-year-old male with a background of Parkinson’s disease is brought to A&E from his care home, with sudden onset abdominal pain and bilious vomiting. Abdominal x-ray shows a ‘coffee bean’ sign. He was managed with endoscopic decompression which relieved his symptoms. Two days later, he complains of severe generalised abdominal pain and tells you that he has not opened his bowels for the last 36 hours. On examination, there is severe pain on light palpation.

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