PROBLEM
A 70-year-old man complains of abdominal cramps. What is your impression of this scout film of his abdomen?

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ANSWER
The patient has bilateral inguinal hernias. Note the intestinal gas superimposed over the obturator foramina. No evidence of intestinal obstruction can be seen at this time.

This series of diagnostic quizzes that challenge your ability to read a variety of x-ray films is edited by Dr. Keats, alumni professor of radiology at the University of Virginia School of Medicine in Charlottesville. Emerg Med 40(4):51-2, 2008