Grossly dilated large bowel loops. Dilated bowel with fecal material, predominantly on the right. A kidney/coffee bean sign with a thick inner wall of opposed bowel loops compared single layered outer walls is identified. Additionally, the Frimann-Dahl sign with three dense lines of sigmoid walls converging towards the right pelvis.
Bilateral psoas shadows are obscured. No pneumoperitoneum or air-fluid levels. No abnormal soft tissue densities or calcifications. The chest X-ray shows no sub-diaphragmatic free air and is generally unremarkable.
On single contrast enema, there is a bird beak-like projection on AP imaging, a bird beak sign, outlining the site of obstruction. Minimal contrast is observed traversing past the "beak" towards the right of the abdomen. No opacification of the remainder of the large bowel to caecum or reflux into the small bowel. Contrast flow abruptly cuts off within the sigmoid colon. No extravasation of contrast. Free flow of water-soluble (Gastrograffin) contrast through the rectum. Normal recto-sigmoid ratio.