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Polyp of the Right Colon K. Nagasako 1 , T. Takemoto 1 1The Institute of Gastroenterology, Tokyo Women's Medical College pp.895-901
Published Date 1974/7/25
DOI https://doi.org/10.11477/mf.1403111951
  • Abstract
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 1. The clinician, who relies largely on endoscopy and barium enema, encounters the great majority (about seventy to eightly per cent) of adenomatous polyps in the rectum and lower sigmoid colon.

 The pathologist, on the contrary, insists that more than half of adenomatous polyps exist in the right half of the colon, or the greatest concentration of these lesions per unit of surface area is actually in the cecum.

 We investigated on the distance between the clinical and pathological examination. Two assumptions were possible. First, clinical examinations, especially proctosigmoidoscopy, were more effective for the lower part of the large intestine. So the polyps of the deep colon might have been left undiscovered. Second, the average age of the patients who undergo the clinical examination is lower than that of the autopsied patients. As for the first point, results by recently developed colonoscope may give some clue. Colonoscopy, however, revealed that large part of the polyps also exist in the lower sigmoid and rectum. Therefore, the only possible explanation for the clinico-pathological dissociation is the age difference at the time of both examination. That is to say the polyps grow in the right colon at the evening of life. But no proof of it was done.

 2. Some important points for the colonoscopic examination of polyps were stressed. It is often difficult to find limitted lesions such as polyp just beyond the segment where the colon flexes kneely; hepatic flexture and several parts of the sigmoid colon. It is very important for the colonoscopy to clarify the base of the polyp ; present or absence of the stalk.


Copyright © 1974, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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