Question: A 71-year-old man with insulin-dependent diabetes mellitus was admitted witha 48-hour history of abdominal pain and vomit-ing. Clinical examination was notable for ab-dominal tenderness. A plain abdominal radio-graph is shown. What is the diagnosis?

Look on page 1283 for the answer andsee the Gastroenterology website (http://

www.gastrojournal.org) for more informa-tion on submitting your favorite image toImage of the Month.

CLARE BRENNER, M.B., F.R.C.R.SAMUEL HAMILTON, M.D., F.R.C.R.The Adelaide & Meath Hospital

Dublin, Ireland

r 2000 by the American Gastroenterological Association0016-5085/00/$10.00

doi:10.1053/gast.2000.8488

Image of the MonthSanjiv Chopra, Section Editor

GASTROENTEROLOGY 2000;118:1000