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April 4, 1980

Extrinsic Barium Collection on Barium Enema Examination

JAMA. 1980;243(13):1367-1368. doi:10.1001/jama.1980.03300390051026

History  A 53-year-old man was admitted with epigastric pain of five to six days' duration. Normal stools had become tarry. The patient had a history of surgery 11 years ago for perforated peptic ulcer. Barium enema examination revealed findings as on Fig 1 (preevacuation) and Fig 2 (postevacuation). Figure 3 is a preevacuation spot film.

Diagnosis  Tubular communicating duplication of the descending colon.In this case it was not certain whether the positive guaiac test on stool was caused from duodenal ulcer seen on gastrointestinal examination or duplication of the colon. Gastric surgery (vagotomy and pyloroplasty) and excision of the colon duplication were performed, and the patient was later discharged. He has had a number of subsequent admissions for other problems, the last being Dec 8 to 11, 1975, but has had no difficulties related to the colon and no further bleeding. Note the mobility of the duplicated segment (Fig