Chronic Nonhealing Colonic Ulcer

Abstract

A 53-year-old man presented with a positive fecal occult blood test and denied having symptoms of fever, abdominal pain, fullness, nausea, diarrhea, or constipation. Colonoscopy showed a single irregular polypoid lesion with a deep central ulcer in the hepatic flexure colon (Figure A). The rest of the colonic mucosa appeared normal. The biopsy specimen was negative for colon cancer or inflammatory bowel diseases such as Crohn’s disease. Next, a barium enema was performed, which unexpectedly revealed a fistula tract between the hepatic flexure colon and the gallbladder (Figure B, arrow).