<prompt> 30-year-old patient with acute abdomen pain with obstipation. X-ray given below. Diagnosis?Small bowel obstructionLarge bowel obstructionGastric outlet obstructionDuodenal atresia  <response>: Ans. a Small bowel obstructionRef: Bailey and Love 26th edition, Page 1189 Nowadays for suspected small bowel obstruction erect X-ray is not done unless specifically required This X-ray shown here is X-ray abdomen erect -- showing multiple air fluid levels in stepladder pattern Supine X-ray shows more of gas filled small bowel loops Erect X-ray shows air fluid levels with air at the top and fluid below 2-5 air fluid levels are normal. 