This is an unusual, and we think first reported, case of gastric outlet obstruction due to herniation of the caecum and ileum through the epiploic foramen. It demonstrates the usefulness of contrast CT in the pre-operative evaluation of such patients presenting with acute abdomen. What I particularly like is the hand drawn operative findings by the surgeon. In these days of multi-media and graphics designers it is good to be reminded that the best way to demonstrate something may be to simply draw it with a pencil!

Gastric outlet obstruction from a caecal volvulus, herniated through epiploic foramen: a case report