An 84-year-old man presented with obstipation and abdominal distention. Flat plate showed distended small and large bowel. Flexible sigmoidoscopy to 25 cm was unremarkable. Passage of a colonoscope beyond a redundant sigmoid loop revealed the lesion shown. The lesion was biopsied.
The patient was taken immediately for gastrografin enema to determine if the lesion was totally obstructing. Patency might allow bowel prep and elective surgical treatment.
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An oblique fluoroscopy view is shown. The study showed total obstruction at the junction of descending colon and sigmoid. The patient was fluid resuscitated and taken emergently to the operating room.
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