Young Man With Abdominal Cramps and Bloody Stools

Abstract

A 35-year-old man presented with left side abdominal cramps and bloody stools that persisted for 1 week. Physical examination revealed a body temperature of 38.5 °C (101.3 °F), normoactive bowel sounds, and left lower quadrant tenderness. A standing abdominal radiograph showed a nonspecific small bowel gas pattern and a smooth radiolucent descending colon without haustration (Figure 1), indicating a typical lead pipe sign. Ultrasonography of the left side of the abdomen revealed a straight, smooth-walled descending colon filled with blood-like heterogeneous echogenic materials (Figure 2 and Video E1).