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November 18, 1983

A Large Colonic Intraluminal Mass in a Young Man With Chronic Diarrhea

Author Affiliations

From the Department of Radiology, Northwestern University Medical School, Chicago.

JAMA. 1983;250(19):2675-2676. doi:10.1001/jama.1983.03340190077039

History  A 22-year-old man with a 12-year history of intermittent abdominal pain and diarrhea had an exacerbation of the diarrhea and weight loss. Representative roentgenograms of an air-contrast barium enema examination (Figs 1 and 2) are illustrated. A single-contrast barium enema study performed five years earlier had shown similar findings.

Diagnosis  Giant postinflammatory pseudopolyposis of Crohn's colon.

Comment  The supine roentgenogram from the air-contrast barium enema examination (Fig 1) demonstrated multiple sessile- and filiform-appearing polyps in the ascending, transverse, and descending colon. The sigmoid colon and rectum (not shown) were normal. A spot x-ray film (Fig 2) of the hepatic flexure showed a 5-cm polyp that had incorporated several filiform polyps. The presence of multiple filiform- and sessile-appearing polyps in a patient with a long history of gastrointestinal complaints indicative of inflammatory bowel disease should strongly suggest postinflammatory pseudopolyposis. The sparing of the rectosigmoid and asymmetric involvement of the more