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Fig. 4 —85-year-old woman with chronic diverticulitis and colonic obstruction who presented with 3-month history of pencil-thin stool and bloating. Left posterior oblique spot image from double-contrast barium enema examination shows segment of marked narrowing in sigmoid colon causing complete retrograde obstruction with no colonic filling more proximally. Note tapered distal margin (arrow) and distorted folds within narrowed segment. Nevertheless, differentiation from malignant tumor is more difficult because of incomplete filling of diseased segment without visualization of proximal margin.