Dr. Roland G. Ware: This 88-year-old woman was admitted to the hospital three years ago when she had an episode of passing black stools. She had been taking iron tablets because she thought herself anemic. Her hemoglobin was 13 gm/100 ml and guaiac examinations of the stool were negative. A barium enema revealed a filling defect in the tip of the cecum. Surgery was deferred because of the patient's age and general debility with asthma, emphysema, documented evidence of two myocardial infarctions, and because the guaiac tests on the stools were negative. Her physician discouraged the use of iron tablets and she ceased to have dark stools. The hematocrit remained within normal limits and several guaiac examinations of the stools were negative.
She continued to complain of intermittent generlized crampy abdominal pain associated with occasional episodes of diarrhea and constipation. The barium enema examination was repeated one year before admission
Mattoso LP, Clouse ME. Unusual Lesion of the Cecum. JAMA. 1965;191(11):932–933. doi:10.1001/jama.1965.03080110056015