A 21 year old woman is brought to the emergency depart at 6 pm with complains of abdominal pain since 7 hours. The pain is colicky in nature, maximum in the right lower quadrant. The patient had several bowel movements since onset of pain. Her temperature is 36.6 degree Celsius, heart rate of 58 beats per minute, respiratory rate 16/minute and blood pressure of 96/58 mm Hg. On examination, the abdomen was distended with diffuse tenderness and the patient resisted deep palpation. The patient had her last meal on the night before and is a known case of anorexia nervosa.
Her investigations reveal a total WBC count of 6200 and normal renal, liver and coagulation parameter. CT abdomen and pelvis is shown. Identify the signature sign and the probable cause. Source: Ibrahim, Deena et al. Western Journal of Emergency Medicine 11.2 (2010): 197–200.
