AXR (above left) shows an extremely dilated structure in the mid abdomen filled with air and small radiopaque objects. Axial CT without contrast of the abdomen (above right) shows the dilated structure to be a loop of bowel containing stool and radiopaque foreign bodies. AP image from an enema (below left) shows a dilated ascending colon, an extremely dilated transverse colon, and normal caliber of the descending colon and sigmoid colon. Oblique views of the splenic flexure (not provided) showed a very tight stricture there.
The diagnosis was a very tight stricture at the splenic flexure due to previous necrotizing enterocolitis. The radiopaque objects were a mixture of plant seeds and shells from nuts and various other ingested foreign bodies (below right) that could not make it past the stricture.
