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Dilated loops of small bowel without colonic distension are seen on this abdominal x-ray. There is no subdiaphragmatic free gas present.
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Abdominal x-rays revealed dilated loops of small bowel without colonic distension and no free subdiaphragmatic gas (Fig. 1).
Features of both small and large bowel obstruction with moderate ascites can be seen on the computed tomography of the abdomen (left arrow). A transition point was seen in the proximal transverse colon without an obvious lesion (right arrow).
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Computed tomography (CT) of the abdomen revealed features of both small and large bowel obstruction with moderate ascites (Fig. 2).
On the high power (100x magnification) haematoxylin and eosin stained histopathological specimen from the right hemicolon, the single filing of polygonal cells into linear cords and the presence of intracytoplasmic and perinuclear vacuoles can be seen (see arrow). These are features typical for lobular carcinoma of breast origin.
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Histopathology revealed the terminal ileum stricture to be metastatic carcinoma with morphology and immunoprofile in keeping with metastatic lobular breast carcinoma (oestrogen and progesterone receptor positive; Her2 negative) (Fig. 3).