Approximately four months prior to admission, this 68-year-old male began having "sharp, shooting pains" in the lower abdomen. A barium enemaA barium enema is a radiological study of the colon and rectum performed using barium as a contrast agent. at that time was reported as normal. Two months later, the barium study was repeated because of persistent diarrhea and showed a filling defectAny localized defect in the contour of the stomach, duodenum, or intestine, as seen in the radiograph after a barium enema. in the transverse colon. The patient refused to undergo an exploratory laparotomy. During the week prior to this admission, the patient had recurrent diarrhea, cramping abdominal pain, and marked rectal bleeding. He was hospitalized and required 2500 ml of blood to return his hematocrit to normal. A colectomy was done from the hepatic flexure to the rectosigmoid.
The segment of colon contained numerous polyps and an annular tumor which was 6.7 cm in diameter. Proctoscopic examination of the ascending colon revealed two more polyps which were removed.