A 70-year-old man who developed abdominal distension and constipation one week after a total knee replacement. He did not have any recent digestive tract symptoms. His abdomen was massively distended, soft, and there were few bowel sounds.
The plain abdominal radiograph showed prominent distension of the ascending and transverse colon. The descending and sigmoid colon contained gas and was not distended. He had been on opiates, which were ceased. The pseudo-obstruction resolved of its own accord over the next two days.
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