Carcinoma of the ascending colon and its treatment : with the record of two cases / by W. McAdam Eccles.

  • Eccles, William McAdam, 1867-1946.
Date:
1900
Catalogue details

Licence: In copyright

Credit: Carcinoma of the ascending colon and its treatment : with the record of two cases / by W. McAdam Eccles. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    Reprinted from the BniTisn Medical Jotoval, January 13th, 1900. CARCINOMA OF ASCENDING COLON AND ITS TREATMENT, WITH THE RECORD OF TWO CASES. By W. McADAM ECCLES, M.S.Lond,, F.R.C.S.Eng., Assistant Surgeon West London Hospital and City of London Truss Society. The comparative rarity of malignant disease of the ascending colon causes the publication of every case to be a matter of some interest, and it is on this account that I venture to re- cord the two following cases. It is a fact that while the ciecum is almost as frequently attacked by carcinoma as is the sigmoid flexure, yet the ascending colon is very much less often affected by the same disease than the descending colon, and only slightly more frequently than the transverse colon with its hepatic and splenic flexures. These general statistics are, however, from the records of published cases, and they may not be so accurate if all the cases that occur were tabulated, but the main statement^ may be taken as true that the ascending colon is one of the less common sites in which malignant dis- ease begins. In these remarks I have purposely excluded the rectum, which is undoubtedly the region where carcinoma most usually attacks the bowel. There does not appear to be any very clear reason why the ascending colon, and to a minor degree the descending colon, should be to such an extent exempt from the appearance of a cancerous growth in its walls. The blood supply of the caecum is derived from what may be taken as a terminal branch of the superior mesenteric artery, the ileo-coJic, but the ascending colon, transverse colon, and descending colon, are supplied by vessels which freely anas- tomose with one another, the two former by branches from the superior mesenteric, and the last by a branch from the inferior mesenteric. The sigmoid colon with the rectum are on the other hand nourished by arteries which again are of the nature of terminal vessels. Whether such a disposition of the arterial supply has any connection with the determina- tion of the deposit of carcinoma, it is impossible to say, but it may be a factor in the causation of the disease. It is also signiflcant that the ciecum, the sigmoid, and the rectum are all dependent parts of the intestinal tract, and this, in addition may be another slight factor. The lymphatics of the ascending colon pass to the meso- colic lymphatic glands, lying between the layers of the meso- colon, and sending their efferent vessels to the glands placed