Polyposis of the Colon T. Tajima 1 , I. Tabata 1 , S. Toda 1 , A. Munakata 1 , M. Kon 2 , M. Aho 2 1Dept. of Matsunaga Internal Medicine, Hirosaki University School of Medicine 2Dept. of Oh-uti Surgery, Hirosaki University School of Medicine pp.751-761
Published Date 1973/6/25
DOI https://doi.org/10.11477/mf.1403108535
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 From 1968, when colonofiberscope was first developed, we in the Matsunaga Department of Internal Medicine, School of Medicine, Hirosaki University, have so far come across 17 cases of familial polyposis of the colon, a disease generally considered of rare occurrence, in 3 families along with 6 cases of PeutzJehgers' syndrome in another 3 families. Seven patients with polyposis of the colon have also undergone surgical intervention in the Ouchi Department of Surgery. Based on our experiences and with reference to the literature, we have described diagnosis and treatment of polyposis of the colon. Eight such cases encountered in one family are also illustrated in this paper.

 Diagnosis of familial polyposis of the colon can easily be made x-ray study of the colon is combined with colonofiberscopy. Only atypical cases merit special attention ; otherwise they may be treated as colon carcinoma, as is exemplified in a case here presented. Subjective symptoms can entirely be absent in the young. Once a diagnosis of polyposis of the colon is established, it is essential to examine the family as well. The youngest we were able to diagnose was a 7-year-old boy.

 The rate of malignant degeneration in polyposis of the colon was very high in our experiences ; it was 41 per cent as a whole, while in persons over the age of 30 it was as high as 75 per cent. As prophylactic measure as well as for radical cure, total colectomy would be most desirable. Choice of surgical procedure naturally depends on individual situation.

 Good results have been obtained in the young by total resection of the colon and rectum or ileorectostomy. The mean age of patients who have undergone surgical correction in our collected series in Japan is 28.6 in non-cancerated cases ; in those with malignant changes it is 37.7. As no malignant finding has been demonstrated in patients under 20, we are of the opinion that clinical follow-up of polyposis of the colon may be allowed to go on until the age of 20 ; thereafter surgical intervention should be done at the earliest opportunity.

Copyright © 1973, Igaku-Shoin Ltd. All rights reserved.


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