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A loop transverse colostomy can be performed as an effective method of relieving acute colonic obstruction. In the setting of disseminated intra-abdominal malignancy and resultant abnormal anatomy, the procedure is frequently underestimated. By securing a coin in the right upper quadrant and obtaining a plain film of the abdomen, the location of the proposed colostomy relative to the transverse colon can be estimated pre-operatively. This facilitates less dissection of the peritoneal attachments in order to mobilise the colon to the desired site.