Barium Enema Study Research Articles

Growth rates and histopathological outcomes of small (6–9 mm) colorectal polyps based on CT colonography surveillance and endoscopic removal

Background and aimsThe natural history of small polyps is not well established and rests on limited evidence from barium enema studies decades ago. Patients with one or two small polyps...

Barium appendicitis.

We have presented a case of barium appendicitis, which is a rare complication of barium enema studies. Barium sulfate is used widely for gastrointestinal radiographic studies and is associated with few complications. Clinicians need to be fully aware of this complication.

Pulsion diverticula of the rectum: Radiological diagnosis and clinical implications.

The aim of this study was to investigate the appearance of acquired rectal diverticula on barium enema and computed tomography (CT) and to review the pertinent clinical data about this entity. This series included 3 men and 6 women, who ranged in age from 47 to 82years (average: 64years). Air-contrast barium enema in 6 patients with history of anorectal disease or obstructed defecation demonstrated rectal diverticula. In these cases, multiple radiographs of the rectosigmoid region were obtained in upright position while the patient was relaxing or straining without any attempt to evacuate the barium. In 3 cases, the lateral rectal diverticula were incidental finding on CT studies that were performed for various unrelated abdominal complaints. Pulsion type of diverticulum presenting as a wide-neck outpouching was detected on the lateral rectal wall in 5 and on the posterior wall in 4 patients. They measured 2-3cm in diameter when filled with contrast material or gas, and became even larger when the intraluminal pressure was increased by straining. Pulsion diverticula of the rectum present as a wide-neck outpouching of the lateral or posterior rectal wall in adult patients. This acquired abnormality is usually associated with coexisting anorectal lesions or defecation disorders. The practising radiologists and colorectal surgeons should be aware of this uncommon condition, its appearance on barium enema and other imaging studies, and its clinical implications.

Laparoscopic-assisted transanal pull-through for hirschsprung's children older than 3 years: A case series.

Context:Hirschsprung's disease (HD) is a congenital anomaly affecting the enteric nervous system commonly the rectosigmoid region. Treatment is surgical where the aganglionic segment is resected, and bowel continuity is restored by a coloanal anastomosis. In 1999, Georgeson et al. proposed a new technique of primary laparoscopic-assisted pull-through for HD as a new gold standard.Aim:The aim of the study was to evaluate the outcome of the laparoscopic-aided transanal pull-through procedure for the management of HD in children older than 3 years of age.Methods:This study was conducted on 15 consecutive patients presented to a university hospital, diagnosed as having HD relying on their clinical features, barium enema study and rectal biopsy. In all cases, laparoscopic-assisted transanal pull-through was attempted. The laparoscopic part included transition zone identification, seromuscular biopsy for fresh frozen histopathology and sigmoid and rectal mobilisation as much as possible down the peritoneal reflection. The transanal part included mobilisation of the rectal lower segment by 2–3 cm, resection till the ganglionic segment, and full-thickness two-layer coloanal anastomosis was done.Results:Early complications occurred in eight cases: enterocolitis in four cases and perianal excoriation occurred in four cases. There were no cases of anastomotic leak. Late complications occurred in seven patients: four cases developed stricture at the site of coloanal anastomosis and three cases experienced enterocolitis at 6 and 9 months postoperatively.Conclusion:Laparoscopic-aided transanal pull-through procedure is a safe, feasible modality for the management of HD in children more than 3 years.

Radiographer role extension in Oman – Current practice and future opportunities

IntroductionRadiographers in Oman are believed to be engaged with varying levels of role extension however the nature and extent of this currently unknown. The aim of this study was to investigate role extension for radiographers in Oman, and to evaluate radiographers and the radiologists’ opinions and attitudes toward role extension. MethodsA cross sectional study of radiographers and radiologists at 13 major hospitals in Oman was used. A total of 189 radiographers and 77 radiologists were invited to complete a questionnaire seeking information on current and possible future role extension activities. ResultsThe overall response rate was 80.4% for radiographers and 63.6% for radiologists. Approximately half (53.3%) of the radiographer respondents reported they carry out examinations traditionally performed by radiologists (i.e. role extension); this was primarily in gastrointestinal and barium enema studies. Fewer (21%) reported being involved in image interpretation, most commonly in accident and emergency examinations. Forty percent of radiographers reported involvement in intravenous injections, most commonly for CT and intravenous urography procedures. Both radiographers and radiologists supported the involvement of radiographers in a range of examination types however responses vary within and between hospitals. ConclusionThis study concluded that radiography role extension activities are widely implemented at hospitals in Oman and that radiographers have sufficient skills and education for participating in these activities. Implications for practiceThe involvement of radiographers in role extension activities is believed to be cost and time effective, improve teamwork and has potential for significant service delivery benefits.

1630 Rectal Duplication in a Middle-Aged Adult Presenting With Constipation and Abdominal Mass After Hysterectomy

INTRODUCTION: Alimentary tract duplications are rare congenital malformation that usually presented since childhood. CASE DESCRIPTION/METHODS: A 43–year-old female presented with constipation and progressive enlargement of abdominal mass for 4 years. Her constipation symptoms started after she underwent hysterectomy for myoma uteri. She had straining and fecal soiling that was refractory to laxatives. Physical examination revealed a 25-cm non-tender hard mass at mid-lower abdomen. Digital rectal examination showed anal wink, normal sphincter tone, and empty rectum. Paradoxical anal sphincter contraction was presented while pushing. Other physical findings were unremarkable. CT abdomen showed marked dilatation of rectosigmoid colon with feces content with an abrupt change of caliber at upper rectum. Small bowel was not dilated. Barium enema study was shown in Figure 1. Colonoscopy showed a 1.5-cm opening of a large blind pouch at 10 cm above anal verge. Anorectal manometry revealed dyssynergic defecation type II with rectal hyposensitivity with delayed balloon expulsion time. The patient underwent a complete transabdominal resection of the duplication with temporary loop sigmoid colostomy. Gross findings showed a large uniloculated cyst (Figure 2). Pathological findings showed a cystic lesion lined by complete colonic wall (Figure 3). DISCUSSION: Rectal duplications are rare congenital anomalies (1/200,000 live births) and seventy percent of them are diagnosed before the age of two. They can be classified as type I (cystic) and type II (tubular) with or without communication to rectum or perineum. The wall of the duplications is typically lined with complete rectal wall. Surgical removal is indicated as it prevents septic and carcinogenic complications [1]. Our patient’s symptoms interestingly occurred late in adulthood after surgery. Removal of uterus and myoma uteri might change the angle of the duplication’s opening. Also, the presence of dyssynergic defecation might contribute and cause gradual accumulation of fecal content inside. Three months post-operative anorectal manometry still showed dyssynergia but improved rectal sensitivity. At present, our patient has bowel movement every 1-2 days per colostomy with minimal usage of laxative and is currently undergoing biofeedback training before colostomy closure.

1524 Using Transillumination to Aid Dilation of a Severe Colorectal Anastomotic Stricture

INTRODUCTION: Colorectal anastomotic strictures are common complications of low anterior resection. Strictures in the lower rectum can be treated with direct digital dilation, but if in the upper rectum, endoscopic balloon dilation or electrocautery can be done. However, both procedures depend on the advancement of the wire through the circumferential scar/narrowed lumen. We present a unique case of endoscopic dilation of a severe anastomotic stricture using an innovative method. CASE DESCRIPTION/METHODS: A 44-year-old male with a history of rectal adenocarcinoma s/p low anterior resection with colorectal anastomosis and loop ileostomy formation presented to the GI clinic for constipation. Barium enema study revealed a stricture at the anastomotic site. A flexible sigmoidoscopy confirmed a severe anastomotic stricture, which could not be traversed nor lumen distal to the stricture visualized. And despite multiple attempts the guidewire could not pass through the stricture. Ten weeks after surgery, a pediatric colonoscope was passed through the ileostomy and advanced to the area of the stricture. Position was confirmed with fluoroscopy. At the same time an adult upper endoscope was inserted into the rectum and advanced to the stricture. The pediatric colonoscope was used to transilluminate the stricture and a needle was then used to puncture through the stricture under direct visualization. A guidewire was advanced through the newly created lumen retrograde and the tract was dilated up to 8 mm. A double pigtail plastic stent was inserted across the newly created tract. On repeat colonoscopy three weeks later, the double pigtail stent was removed and the stricture was dilated up to 15 mm. On subsequent colonoscopy, the stricture was dilated to 18 mm and the patients loop ileostomy reversed. The stricture was dilated again to 20 mm via Flexible sigmoidoscopy a month after the reversal after which constipation and bowel habits significantly improved. DISCUSSION: In patients who develop severe colorectal anastomotic strictures after a low anterior resection, endoscopic dilation can be challenging. In such patients ileoscopy and colonoscopy can be done simultaneously and using transillumination, position can be confirmed and a needle can be used to create a lumen through which a guide wire can be passed, allowing for serial dilation. Endoscopic dilation, should be tried and exhausted before considering surgical correction of a stricture, which can be difficult and increase morbidity.

Crohn\u2019s disease in a developing African mission hospital: a case report

BackgroundA case is reported of innocuous intestinal obstruction requiring surgical intervention that was confirmed to be Crohn’s disease histopathologically in a resource-constrained rural mission hospital in Cameroon.Case presentationA 70-year man of Kumbo origin from Northwest region of Cameroon with a history of crampy right lower-quadrant abdominal pain, non-bloody, non-mucoid diarrhea alternating with constipation presented to my institution. Abdominal examination of the patient revealed an ill-defined mass in the right iliac fossa and visible peristalsis. An abdominal computed tomographic scan and barium enema study confirmed a complex ascending colonic and cecal tumor. The patient underwent exploratory laparotomy. The intraoperative finding was a huge complex inflammatory mass involving the cecum, terminal ileum, and sigmoid colon. He subsequently had sigmoidectomy with end–to-end sigmoidorectal anastomosis and a cecal resection, and the proximal ascending colon was exteriorized because end mucoid fistula and terminal ileostomy were performed. The histopathological diagnosis confirmed Crohn’s disease. The patient subsequently received five courses of adjuvant chemotherapy consisting of azathioprine, methotrexate, mesalamine, and methylprednisolone. He had complete disease remission and subsequently had closure of ileostomy with satisfactory postoperative status. The most recent follow-up abdominal computed tomographic scan and colonoscopy revealed disease-free status. The patient is also currently receiving a maintenance dose of rectal mesalamine and oral omeprazole treatment. He has been followed every 2 months in the surgical outpatient clinic over the last 16 months with satisfactory clinical outcome.ConclusionsCrohn’s disease is uncommon in Africa, and this entity is encountered sparingly. The signs and symptoms of Crohn’s disease overlap with many other abdominal disorders, such as tuberculosis, ulcerative colitis, irritable bowel syndrome, and others. Several publications in the literature describe that it is difficult to make an accurate diagnosis of this disease, despite the fact that many diagnostic armamentaria are available to suggest its presence. Most of the patients with Crohn’s disease are treated conservatively, and a few may require surgical intervention, especially those presenting with complications such as intestinal obstruction, perforations, and abscess as well as fistula formations, as seen in this index patient. Crohn’s disease is considered by many to be a very rare disease in Africa. It is interesting to know that Crohn’s disease, which affects mainly young adults, may debut at any age. The rarity and clinical curiosity of this entity suggested reporting of my patient’s case. Evidence-based up-to-date information on Crohn’s disease is also documented.

A Case of Barium Enema–Induced Anal Fistula in a Long-term Care Resident: An Imperative to Avoid Barium Enema as a Screening and Diagnostic Tool in the Elderly

The use of barium enema study has decreased as lower GI endoscopy becomes more prevalent. However, it is still used in several clinical settings given benefits of sedation avoidance, less invasiveness and low cost. Even though barium enema is a relatively safe study, complications may result in rare cases. Colonic perforation is the most frequent serious complication, occurring in 0.02 to 0.04% of patients. Extra peritoneal perforation is usually less catastrophic than intra peritoneal perforation, but may result in pain, abscess, rectal stricture or fistula. The risk factors for complication are a recent colonoscopy especially with biopsy, impaired tensile strength of the bowel wall due to age, overinflation of the balloon and trauma from the enema.

Spectrum of findings on barium enema examination in Benin City

Background: In the Western world, barium enema has largely been replaced by computed tomographic (CT) colonography or virtual colonoscopy using the three-dimensional fly-through software. But barium enema remains relevant in our environment because of its availability and affordable cost as compared to cross-sectional imaging. Aim: To document the common pathologies seen on barium enema examinations in Benin City, Nigeria. Materials and Methods: All cases of barium enema performed at St. Bridget X-Ray Centre, a private radio-diagnostic outfit in Benin City, between January 2013 and December 2014, were retrospectively reviewed. The biodata, clinical information, and radiological diagnoses were collated and entered into the Statistical Package for Social Sciences (SPSS) software and then analyzed. Those with inadequate details were excluded from the study. Results: Two hundred and sixteen patients who had barium enema for various indications were reviewed; the males were 135 (62.5%), whereas the females were 81 (37.5%). Constipation (53, 23.0%) was the most common clinical indication, followed by hematochezia (50, 21.7%), abdominal pain (32, 13.9%), colorectal mass (26, 11.3%), and abdominal swelling (12, 5.2%). Colonic carcinoma (39, 20.8%) was the most common diagnosis on barium enema. This was followed by Hirschsprung’s disease (20, 15.4%), ulcerative colitis (15, 11.5%), megacolon (12, 9.2%), and colonic stricture (11, 6.2%). These findings were more in males (88, 67.7%) than that in females (42, 32.3%). Conclusion: This study has enumerated the common indications and common radiological findings on barium enema study in our environment. Furthermore, this study has also buttressed the fact that barium enema is still reliable in making diagnosis in environment where CT scan is either unavailable or costly.

Nurse-run clinic for functional bowel disorders at a district general hospital

Background: Functional bowel disorders (FBDs) include constipation, diarrhoea, bloating and unspecified FBD. FBDs have serious symptoms that impact quality of life and require effective resource management to reduce their impact on clinical services. Aim: The experience of a nurse-led FBD service in a UK district general hospital is presented. The service is protocol driven and led by a colorectal clinical nurse specialist (CNS), with appropriate consultant supervision. Referrals are from primary care and consultant clinicians. Method: Demographics, investigations, treatments and outcomes were analysed using a prospectively run database of the clinic's patients from 2005 to 2016. Results: There were records of 980 patients (median age 56 years; 115M:865F); 60.1% had diarrhoea alone, 36.5% had constipation alone and 3.4% had both. Investigations included barium enema, endoanal ultrasound and transit study. Treatments included rectal irrigation (59.7%), laxative (53.2%), enema (12.3%), anti-diarrhoeal (6%), bowel training (2.4%) or another drug (1.8%). Conservative management was successful in most patients, and only 83 (8.4%) patients were referred for surgery. Conclusion: The nurse-led service is safe, effective and has good outcomes, with a low surgery conversion and high patient satisfaction.

Diverticulosis among patients referred for barium enema studies at Dr George Mukhari Academic Hospital, Ga-Rankuwa, Pretoria, South Africa

Background: A possible increasing trend in the incidence of diverticulosis was observed in adult patients referred to the Diagnostic Radiology department of Dr George Mukhari Academic Hospital (DGMAH), Ga-Rankuwa, Pretoria, for barium enema studies. The study will be the first to document the magnitude of this condition at our hospital since its inception. Objective: The aim of this study is to evaluate the current prevalence of diverticulosis at DGMAH Ga-Rankuwa whose patients are predominantly South Africans of African descent. Materials and Methods: We reviewed the medical records of all adult patients referred to DGMAH for barium enema investigations for 1 year. Barium enema studies of 166 patients who met the inclusion criteria were systematically evaluated radiologically for the presence of diverticulosis. Data from the records were analyzed using the Statistical Package for Social Sciences (SPSS, version 22.0) software program. Results: The patients' ages ranged between 18 and 95 years, with a mean age of 60.1 years. From the records analyzed, 77.7% were radiologically negative, whereas 22.3% were positive for diverticulosis. There was a female preponderance (23 cases [62.2%] among females versus 14 cases [37.8%] among males; P Conclusion: This study demonstrates a possible trend of diverticulosis previously unrecorded in barium enema studies at DGMAH, probably attributable to the effects of urbanization and higher consumption of refined carbohydrate with low fiber residue.

Interdisciplinary investigation of occurrence of diverticular disease among patients referred for barium enema and colonoscopy studies at Dr. George Mukhari Academic Hospital, Ga-Rankuwa, Pretoria, South Africa

Background: Diverticular disease (DD) is believed to be a disease which is prevalent in developed countries. Contrary to this belief, DD has been reported with an increasing trend in prevalence in Africa for the past four decades. Objectives: The objective of this study was to highlight the increasing trend of DD and to corroborate barium enema findings obtained from Diagnostic Radiology Department, with colonoscopy results from the Surgery Department at Dr. George Mukhari Academic Hospital. Methods: Results for barium enema and colonoscopy investigations of all the patients referred over a 1-year period were retrospectively reviewed by two independent research groups; each of these groups was unaware of the research carried out in the Departments of Diagnostic Radiology and Surgery. Data from the records were analyzed with the Statistical Package for the Social Sciences (IBM SPSS, version 22.0), New York, USA, version 22.0. Results: Barium enema results of 166 patients were evaluated for DD, and out of these, 129 patients (77.7%) were negative, while 37 patients (22.3%) (95% confidence interval = 19.07–25.50) were positive. A review of 384 colonoscopy results also revealed positive evidence for 47 patients (13.5%) (95% confidence interval = 10.30–17.50) for DD and 337 patients (86.5%) were negative. The findings of barium enema and colonoscopy investigative studies were similar for female preponderance, diffuse pattern of distribution of DD and the mean age of patients. Conclusion: The two studies corroborate each other and have produced the highest number of diagnostic yield for DD in one year, in Africa.

Contrast Enema Examination: Technique and Essential Findings: RadioGraphics Fundamentals | Online Presentation.

Barium enema studies continue to provide important and unique information to clinicians in an era of more advanced cross-sectional imaging.

Colobronchial fistula: the pathogenesis, clinical presentations, diagnosis and treatment.

Colobronchial fistula (CBF) is rare and easy to be delayed in clinic. There is no systemic study about this disease. The pathogenesis, clinical presentations, diagnosis and treatment of CBF were analyzed in this study. The clinical data from 37 cases of CBF, which included one case in our institute and the other 36 cases in literature from January 1960 to August 2016, were reviewed and analyzed. The etiology, clinical presentations, diagnostic and therapeutic methods, and outcomes were summarized. The causes of CBF included Crohn's disease, postoperative intraperitoneal adhesion, diaphragmatic hernia, pulmonary infection or abscess, colonic malignancy, colonic interposition, radiation, hyperthermic intraperitoneal chemotherapy (HIPEC), diaphragmatic mesh repair, pulmonary tuberculosis and pyonephrosis. Based on the anatomical location and the causes of fistula, CBF were divided into four types: type I, CBF secondary to the adhesion among colon, diaphragm and lung; type II, CBF secondary to diaphragmatic hernia; type III, CBF secondary to sub diaphragmatic abscess or emphysema; type VI, CBF secondary to colon interposition. The characteristic clinical presentations of CBF was productive cough with foul smelling sputum (78.38%), most of the patients were finally confirmed the diagnosis by barium enema or water-soluble contrast enema study (67.57%) and computer tomography (CT) scan/with multiplanar reconstruction (16.22%); 35 cases (94.59%) accepted the surgical treatment. Among 31 patients with recorded follow-up data, 26 patients recovered unevenly, but 5 patients died in 1 month after treatment. CBF is a rare but can not be ignored disease. Anything which may induce the direct or indirect connection between colon and lung tissue may result in CBF. Productive cough with foul smelling sputum is the characteristic symptom. Radiological investigations such as barium enema and/or CT scan with multiplanar reconstruction are valuable for the confirmation of CBF. Surgery based on the etiology is the foundation of treatment.

Colonic hemangioma, a diagnostic challenge in young adults with lower gastrointestinal tract bleeding

Abstract Colonic hemangiomas, first reported in 1839, are a rare and often misdiagnosed cause of lower gastrointestinal tract bleeding. We report a case of a 15-year-old girl who presented with the passage of bright red blood after defecation. Diagnostic studies, including plain abdominal radiography, barium enema study, computed tomography scan, magnetic resonance imaging, and colonoscopy, revealed characteristics specific to a diagnosis of colonic hemangiomas. Awareness of the clinical features of colonic hemangiomas may help avoid inappropriate surgical intervention in these patients.

Outcome of Laparoscopic Treatment of Anorectal Malformations in Children.

Operative correction of anorectal malformations (ARMs) remains a challenge in pediatric surgery. The study aimed to evaluate the outcomes of laparoscopic treatment of ARM in children. From 2007 to 2014, we performed 104 laparoscopic-assisted anorectal pull-through procedures in children with a mean age of 11.3±0.4months and ARMs. Clinical assessment, surgical durations, complications, and postoperative outcome were investigated. The mean duration of the operation was 126.5±17.2min. Mean intraoperative bleeding was 20±5.7g. Three (2.9%) children required conversion to laparotomy. One (0.9%) child developed a pelvic abscess, requiring an additional intervention. Three to six months after laparoscopic-assisted anorectal pull-through, 72 patients were hospitalized for stoma closure. Good functional results were achieved in 39 (54.2%) patients. On examination of the perineum, 11 (15.3%) patients were found to have mucosal prolapse. The circular symmetric anal reflex to tactile stimulation was confirmed in 53 (73.6%) patients and a tactile weakened anal reflex in 5 (6.9%) children. At the 1-year follow-up, constipation was present in nine (12.5%) patients and soling in two (2.8%) patients. A barium enema study performed after the operation showed good outcomes in 67 (93.1%) patients and fair outcomes in 5 (6.9%) patients. None had a poor outcome. Our experience confirms that laparoscopic-assisted anorectal pull-through enabled complete correction of ARM in the meanwhile avoiding damage to the rectum and anus. Also, the technique of double bipolar myostimulation of muscle complex in laparoscopic ARM might lead to these better results.

Diagnostic reference levels for common paediatric fluoroscopic examinations performed at a dedicated paediatric Australian hospital

Diagnostic reference levels (DRL) of procedures involving ionising radiation are important tools for optimising radiation doses delivered to patients and to identify cases where the levels of dose are unusually high. This is particularly important for paediatric patients undergoing fluoroscopic examinations as these examinations can be associated with a high radiation dose. In this study, a large amount of paediatric fluoroscopic data has been analysed to: establish local DRL, identify the most significant factors determining radiation dose to patients, and modify fluoroscopic techniques to optimise the examination protocols. Paediatric fluoroscopic studies performed at our institution from April 2010 to May 2015 have been retrospectively analysed to determine range, mean, 75th and 95th percentiles of Dose-Area Product (DAP) and fluoroscopic screening time for Micturating Cystourethrography (MCU), Airway, Airway and Swallow, Barium Swallow and Meal, Barium Follow Through and Barium Enema studies. Currently, no Australian paediatric fluoroscopic DRL data are available for comparison and thus our data can only be compared with international published data. No major changes to examination protocols or modification to fluoroscopic techniques were found necessary as our data compared well with the international published values. The dose delivered to patients depend on a number of factors particularly the experience of the operators. However, DRL are also important, as shown in this study, as they enable best practice by providing feedback to the operators on their performance and benchmarking the institution with other institutions.

Gastrojejunocolic fistula after gastrojejunostomy in Ayder referral hospital Northern Ethiopia: A report of two cases.

BackgroundGastrojejunocolic fistula (GJCF) is a late and severe complication of a stomal ulcer after gastrojejunostomy, which develops as a result of inadequate resection of stomach or incomplete vagotomy. The occurrence of perforation in a GJCF is even more a rare complication because long evolution time or latent period is required for its appearance. Patients with this condition usually present with diarrhea, weight loss, feculent vomiting, under-nutrition and features of peritonitis that require immediate surgical intervention.Case presentationWe described two cases of gastrojejunocolic fistula in men aged 60 and 40, first cases of gastrojejunocolic fistula seen in our referral hospital and in the whole region following more than a decade after gastrojejunostomy. Both patients initially presented with watery diarrhea, vomiting of fecal materials, poor appetite and weight loss. Upper GI series or barium enema studies allowed a conclusive diagnosis to be made. Both patients underwent one-stage en bloc resection, and their postoperative course and outcome was one cure and one death.ConclusionAs it is rare phenomenon, high clinical suspicion is very important in the diagnosis of GJCF on patients who manifest with chronic diarrhea, vomiting of fecal matter, abdominal pain and features of malnutrition. Careful preoperative preparation is mandatory before any type of surgical procedure is carried out. Pre-operative nutritional status should be evaluated in patients undergoing corrective surgery. Adequate resection of the stomach after Gastrojejunostomy and complete vagotomy is important to prevention development of GJCF.

Laparoscopic-Assisted Surgery for Malignant Fibrous Histiocytoma Originating from the Descending Colon: A Case Report and Literature Review

Primary malignant fibrous histiocytoma (MFH) localized in the large intestine is extremely rare. We report a first case of MFH in colon that underwent a laparoscopy-assisted colectomy. A 74-year-old female had a 3-month history of blood stool. Barium enema study showed protrusion in the descending colon. Colonoscopy revealed submucosal tumor-like lesion with central ulceration.