An unusual cause of colonic stricture with polyps

Clinical presentation

A 70-year-old man with no history of IBD was admitted to our department with right-sided abdominal pain and bloating. He was a non-smoker and a non-alcoholic drinker. Vital signs on initial examination were within normal range. Abdominal examination revealed a palpable tender mass (5x5 cm) in the right abdomen. Laboratory results were as follows: white cell count, 13.4x10⁹/L; haemoglobin, 13.5 g/dL; platelet count, 311x10⁹/L; erythrocyte sedimentation rate, 64 mm/hour; albumin, 3.62 g/dL; and C-reactive protein, 3.97 mg/dL.

Abdominal CT revealed a thickening of the wall (localised high-density mass-forming lesion) in the ascending colon (figure 1A). Colonoscopy revealed a large polyposis with finger-like projections in the ascending colon (figure 1B). The endoscope could not be inserted beyond this point; however, lower GI radiography revealed a colonic stricture and polypoid lesions (figure 1C). Infectious enteritis and intestinal tuberculosis were excluded based on negative bacterial and tuberculosis cultures...

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