Abstract CANCER of the colon and rectum is the leading cause of death from cancer in the United States. Early diagnosis is particularly important for lesions of this portion of the gastrointestinal tract if optimum cure rates are to be achieved. Carcinomas of the right side of the colon are thought of as being relatively silent lesions producing nonspecific symptoms such as fatigue, weakness, and vague lower abdominal pain. Contrary to this, left-sided carcinomas are frequently more dramatic producing changes in bowel habits, bloody stools, and obstruction. Most important, up to 50% of the latter lesions are palpable on rectal examination.1 When carcinoma of the colon causes intestinal obstruction, the lesion is most frequently left-sided in a ratio of 7 to 1.2 Because of the predominance of left-sided colon carcinomas causing obstruction, physicians frequently fail to consider that right colon carcinoma may cause intestinal obstruction. It is the purpose References 1. Floyd, C.E.; Stirling, C.T.; and Cohn, I., Jr.: Cancer of the Colon, Rectum and Anus in the Colon Review of 1687 Patients , Ann Surg 163:829-837, 1966.Crossref 2. Moyer, C.A., et al: Surgery: Principles and Practice , ed 3, Philadelphia: J. B. Lippincott Co., 1965. 3. Colcock, B.P.: Early Diagnosis in Carcinoma of the Right Colon , Dis Colon Rectum 7:482-485, 1964.Crossref 4. Palumbo, L.T.; Sharpe, W.S.; and Henry, J.S.: Cancer of the Colon and Rectum , Amer J Surg 109:439-444, 1965.Crossref 5. Chang, W.Y.M., and Burnett, W.E.: Complete Colonic Obstruction Due to Adenocarcinoma , Surg Gynec Obstet 114:353-356, 1962. 6. Minster, J.J.: Comparison of Obstructing and Non-Obstructing Carcinoma of the Colon , Cancer 17:242-247, 1964.Crossref 7. Hickey, R.C., and Hyde, H.P.: Neoplastic Obstruction of the Large Bowel , Surg Clin N Amer 45:1157-1163, 1965. 8. Wilder, T.C.; Dockerty, M.B.; and Waugh, J.M.: A Clinical Pathologic Study of Obstructing Carcinomas of the Right Portion of the Colon , Surg Gynec Obstet 113:353-359, 1961. 9. Nickell, D.F., and Dockerty, M.B.: The Five Year Survival Rate in Cases of Completely Obstructing Annular Carcinoma of the Descending Colon and Sigmoid: A Pathologic Study , Surg Gynec Obstet 87:519-524, 1948.
Archives of Surgery – American Medical Association
Published: Jan 1, 1968