Regarding image 1- what clinical history and examination findings would you expect to find at the time it was taken ?
Clinical features of bowel obstruction. Vomiting, abdominal pain, absolute constipation, abdominal distension and tenderness, tinkling bowel sounds and an empty rectum on digital examination.
What are the most likely causes of the clinical and radiological diagnosis?
Large bowel obstruction is usually caused by colonic carcinoma or a diverticular stricture. Hernias and volvulus are a less likely cause, unless there are specific clinical or radiological features. Adhesions do not commonly cause large bowel obstruction.
Why should a chest X-ray be requested in this clinical setting? (Chest X-ray not shown in this OSCE)?
In the setting of an acute abdomen an ERECT chest X-ray should be requested to determine the presence of perforation.
Regarding image 2 (If not already stated) - What procedure has been performed and why?
A radiologically placed colonic stent has been inserted to bridge the colonic obstruction. This allows the patient to recover from the acute effects of obstruction before definitive surgery is performed.
At CT the patient was found to have an obstructing colonic cancer. What staging system(s) do you know for this disease?
The TNM (Tumour/Nodes/Metastasis) or Dukes systems of staging.