The patient is a 66-year-old Ethiopian man who had been diagnosed with carcinoma of hepatobiliary origin a month prior to presentation in Bangkok, Thailand. On presentation a month after his initial diagnosis, he was deemed not to be a surgical candidate due to the presence of liver metastases. Chemotherapy was initiated and the patient was subsequently admitted to the hospital for abdominal pain. A few days later, he underwent a near-total colectomy for pneumatosis coli.

The colectomy specimen showed mural pneumatosis with areas of colonic mucosal necrosis and hemorrhage. Multiple tubular adenomata were present.

Two worm-like organisms grossly identified in the colonic lumen, shown in Images 1-3.