Clinical presentation:
76 year old woman under investigation for a history of weight-loss and anaemia. Presents with acute onset of abdominal pain.

The retrograde progress of the barium suspension has halted at the hepatic flexure, where a complex appearance is seen. It resembles a coiled spring where the hautral pattern is still visible while the lumen is obliterated. In the transverse colon towards the splenic flexure, there is marked mucosal thickening or oedema.

There has been a previous lymphogram. It shows contrast in the mostly normal para-aortic nodes, but expansion and large defects in the nodes on the left side of first lumbar vertebra.