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Fig. 7A —48-year-old woman with nausea and vomiting. True-positive findings were reported. Gasless abdomen and string-of-pearls sign were seen. Supine abdominal radiograph shows paucity of small-bowel gas and suggestion of stretch sign valvulae conniventes in dilated small-bowel loop outlined by air (arrow). Stretch sign is defined as abnormal distention of predominantly fluid-filled small-bowel loops in which luminal gas has striped appearance running perpendicular to long axis of bowel [26].