Acute Abdomen — Plain Radiograph Signs

A 68-year-old man with a history of abdominal surgery 10 years ago presents to the emergency department with acute onset colicky abdominal pain, abdominal distension, and vomiting. On examination, he has visible peristaltic waves and a palpable abdominal mass. Plain abdominal radiograph shows multiple dilated small bowel loops with air-fluid levels and a transition point in the pelvis. What is the most appropriate next step in management?

A 72-year-old woman from Delhi presents with acute onset severe left lower abdominal pain, abdominal distension, and absolute constipation for 3 days. She has a history of chronic constipation and neurological disease (Parkinson's). On examination, she is afebrile, blood pressure 130/80 mmHg, and has mild abdominal tenderness with palpable abdominal mass in the left lower quadrant. Plain abdominal radiograph shows a single massively dilated loop of colon in the left abdomen with a characteristic "bird's beak" appearance at the rectosigmoid junction. What is the most likely radiographic diagnosis?

A 68-year-old man presents to the emergency department with acute-onset severe abdominal pain and vomiting for 6 hours. He has a history of previous abdominal surgery 15 years ago. On examination, he is in distress, with a distended abdomen and hyperactive bowel sounds. Plain abdominal radiograph (supine and erect views) shows multiple dilated small bowel loops with a "step-ladder" appearance, and air-fluid levels at different heights on the erect film. No free air is visible under the diaphragm. What is the most likely diagnosis?

A 68-year-old man presents with acute onset abdominal pain, abdominal distension, and vomiting. Plain abdominal radiograph shows multiple dilated small bowel loops with air-fluid levels and a transition point in the left lower quadrant. Which of the following radiographic signs is NOT typically associated with small bowel obstruction?

On plain abdominal radiograph, what is the significance of the 'coffee bean' sign?