A 63-year-old woman in whom two hamartomatous polyps had been removed by colonoscopic polypectomy 18 years earlier presented with intermittent abdominal pain in the right lower quadrant and melena of approximately two weeks' duration. Colonoscopy revealed a large mass extending the entire length of the ascending colon, which was consistent with an intussuscepted small bowel. The patient underwent a right hemicolectomy with a distal ileectomy and had an uneventful recovery.Panel A shows an endoscopic image of the midportion of the intussuscepted segment of the bowel. Panel B shows a photograph of the surgical specimen with the intussuscepted small bowel, which has passed through the ileocecal valve. A mass measuring 4.0 cm by 4.0 cm is visible at the leading edge of the intussusceptum (arrow). Microscopical examination of the mass revealed an inflammatory fibroid polyp.
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