[Value of radiologic and endoscopic examinations in diagnosing diseases of the large intestine (author's transl)].
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A study was made of 300 surgically treated cases of colorectal cancer during an eight year period. The average age for the disease was 60 years with no sex difference but a low incidence in the younger age group. About 1/3 of the cases presented as emergency and 1/4 with palpable mass. Rectum and sigmoid were the commonest sites, while anal carcinoma was rare. The overall mortality for surgical treatment was 10%. 67.3% were resectable with a mortality of 5%. Although well differentiated adenocarcinoma was the commonest variety, mucinous, colloid and other types were rare. Less than 1/3 of the cases were in favourable Stage A and B, while the majority were advanced. This was the main difference from the reports of western series apart from the rarity of inflammatory and premalignant conditions.
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There is an urgent need for earlier detection of colon cancer, because surgical procedures did not improve the therapeutic results. On the other side the incidence of those tumors is increasing. Early detection should be improved by better education of students, careful anamnesis, regular rectal examination in the basic medical care, more frequent use of rectoscopy without special preparation, wide use of tests for occult blood, life-long control of patients bowel adenomas and polypectomy in any case.
The suspected positive correlation between rectal carcinoma and hemorrhoids was examined in a retrospective study. In patients older than 50 a significant positive correlation could be demonstrated between rectal carcinoma and hemorrhoids. In the group of hemorrhoid patients described it could not be shown that rectal carcinoma was more frequent than in the normal population. In patients older than 40 with hemorrhoids a rectoscopy is always recommended. In this material the colonic enema did not contribute any diagnostic information from which therapeutic consequences could be inferred.
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Proctoscopic examination and rectal and colonic biopsies were performed in 10 clinically normal dogs. There was some variation between individuals in the gross and light microscopic appearance of normal canine large intestine but the findings were distinct from those in disease.
Polyps of distal portions of the large intestine were revealed by rectoromanoscopic examination in 268 patients. In 109 of them solitary and group polyps were found by a colanoscopic examination in proximal portions of ileum, 14 having malignant polyps. In addition, 11 patients had malignant tumors. Polyps in the proximal portions are often found in patients older than 60.
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