A young lady in her early 20s, who became paraplegic from her mid chest and below from a motor vehicle accident, was admitted for sudden colicky abdominal pain and a grossly distended abdomen. She had difficulty passing motion since her injury and opens her bowel almost once every week. This present episode has occurred before but not as severe as this present presentation. She noticed some changes in her bowel habit since 3 months ago. On examination, she had a grossly distended but soft abdomen and per rectal examination reveals a mass compressing the rectum from above. So, what is this mass?

Note: The importance of complete history taking and the falls of making assumptions. I have left out a few things in the history which you can ask? Happy Guessing!