Markedly distended stomach and duodenum, with collapse and transition point at the D3 segment where the duodenum crosses beneath the superior mesenteric artery (SMA). Appearances reflect duodenal obstruction. There is significant narrowing of the aortomesenteric angle to 19 degrees, which is suspicious of SMA syndrome.
No gastric pneumatosis or abnormal enhancement to suggest organ ischaemia.
There is no superior mesenteric vessel swirling or abnormal small bowel configuration to suggest a midgut malrotation/volvulus.
Unremarkable appearance of the remainder of the small and large bowel.