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BMJ Case Reports 2012; doi:10.1136/bcr-03-2012-6007
  • Unusual presentation of more common disease/injury

An interesting cause of faecal occult blood

  1. Stuart Riley4
  1. 1Department of Cardiology, Northern General Hospital, Sheffield, South Yorkshire, UK
  2. 2Department of Pathology, Northern General Hospital, Sheffield, South Yorkshire, UK
  3. 3Department of Surgical Directorate, Northern General Hospital, Sheffield, South Yorkshire, UK
  4. 4Department of Gastroenterology, Northern General Hospital, Sheffield, South Yorkshire, UK
  1. Correspondence to Dr Nicolas Rabb, n.rabb{at}nhs.net

A 69-year-old man presented to bowel cancer screening after testing for faecal occult blood. Initial colonoscopy had been limited by a sigmoid stricture and a barium enema had revealed a suspicious mass in the corresponding area. He was referred for repeat colonoscopy, which showed a hard structure crossing the mid sigmoid colon, with both ends impacted into the bowel wall. A CT scan revealed what appeared to be a small bone impacted in a diverticulum with evidence of recent inflammation and a sealed perforation. The patient had recently been managed conservatively for an episode of diverticulitis at his local hospital but was currently asymptomatic. Owing to the possibility of future complications he underwent a laparoscopic sigmoid colectomy to remove the offending foreign body.

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