44 year-old man, a frequent user of cocaine, who presented with bloody diarrhea. Colonoscopy revealed a range of findings from areas of congestion (upper right) to sessile polyps (upper left) to lesions resembling pedunculated polyps (lower left). Stool cultures were all negative. Biopsies revealed mucosal congestion and inflammation. The tips of the more polypoid lesions showed severe ischemia histologically.