C) The plain film radiographic features are suggestive of cecal volvulus. The bowel dilation is too extreme to be considered normal. Because haustra are identified, this is likely not small bowel, but rather this represents colon. Though the sigmoid colon contains haustra, the haustra are often absent in cases of sigmoid volvulus. Finally, the findings are not typical of intussusception.
What diagnostic imaging test should be ordered to confirm our suspicion?
A) Enema study
B) CT abdomen/pelvis
C) Upper GI and small bowel study
D) None; an exploratory laparotomy is indicated at this point
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