Dr. Donald J. Fleischli: This 43-year-old woman was in good health until six months before admission to the hospital when she became intermittently constipated. Three months later her constipation was accompanied by crampy pain in the lower part of the abdomen. The pain became severe and was accompanied by vomiting. When admitted to a nearby hospital, she was unable to move her bowels. Shortly after admission, however, profuse diarrhea spontaneously developed with relief of obstructive symptoms. Findings from physical examination and routine laboratory studies were within normal limits. A barium enema was performed at that hospital (Figure).
Dr. Laurence L. Robbins: Dr. Tomchik, what do you see to account for her problems?Dr. Frederick S. Tomchik: There is an eccentric, partially constricting lesion in the sigmoid colon. It is somewhat sessile and has a central area of ulceration as well as shelf-like edges which suggest tumor. Carcinoma causing partial
Fleischli DJ, Shea TE. Carcinoma and Colitis. JAMA. 1967;201(12):963–965. doi:10.1001/jama.1967.03130120071020