Case of large faecal accumulation oc curring in a girl, aged 13 years, observed. A rapidly-growing abdominal tumor was not diminished by purgatives, and, as the patient was sinking, an exploratory laparotomy was done. On opening the abdomen the tumor was found to be a focal mass in the mecum and colon. Nothing further was done, as the bowels began to act, and in six days the tumor had entirely disappeared. Worrall (Med. Record, June 30, '88).
Case of impaction of the rectum with water-melon seeds, one quart of which were removed by injections. Ricketts (Cincinnati Lancet-Clinic, Sept. 22, '88).
Case showing the diagnostic associa tion between cancer of the colon and floating kidney. A cancer in the middle part of the ascending colon gave rise to dull aching and pains, which the patient almost certainly associated—at first— with his kidney; and as the mass devel oped the bowel became more and more loaded and distended, the lumbar achings increased on account of pressure upon the psoas and the lumbar nerves. This pressure was especially felt by the genito erural branch, and the patient complained the region of the cord and testis. had these symptoms been associated with blood in the urine they might have sug gested the presence of a renal but there was no history of haematuria. Edmund Owen (Lancet, Apr. 27, '95).
An inquiry into the history and the progress of the case will soon remove any doubt that may have existed.
Sarcoma of the bowel, likewise, is, in the majority of cases, primary, and it commonly gives rise to metastasis. It extends by contiguity and may thus give rise to the dilatation and rigidity of the wall of the bowel. It also appears at an earlier period in life than malignant dis ease elsewhere. Constitutional symp toms are likely to develop before local manifestations. The temperature often is elevated. There may be constipation alternating with diarrhoea.
Case of stricture below the ampullae of Water caused by a small, round-celled, sarcomatous deposit located in second part of the duodenum. The symptoms were: violent pain over the pyloric re gion, large and frequent vomitings, acid regurgitations, and pain in the head. The stomach was much dilated, the vomited matter contained much bile, and in the contents of the stomach were always found a notable quantity of hydrochloric acid and bile and non digested food, especially amylaceous material. Masius (Annales de la Soc.
Medico-Chir., June, '91). .
Case of a woman, aged 32, who came under observation with attacks of pain ful diarrhoea, and a tumor below and to the left of the umbilicus. Laparotomy was performed, and the tumor was then found to involve the jejunum at one metre's distance from the duodenum. The portion of intestine was reseeted, but the patient died the next day. The growth was twenty centimetres in length, and had sharp margins. The affected part of the gut was enlarged to the size of the transverse colon, its lumen also being increased in size. The mes enteric glands were enlarged. At the were seen. The growth was a small round-celled sarcoma, starting on the submucosa, and had infiltrated all the coats of the bowel. Mermet (Bull. de la Soc. Anat. de Paris, Nov., '96).
Case of myosarcoma of the small in testine in a man, 30 years of age, pre senting the following symptoms: Pain in the left flank, constipation followed by diarrheea, emaciation, and a smooth surfaced ovoid tumor in the left side of the abdomen, movable and tender. Operation showed a tumor of the small intestine, which was removed by resec tion of the bow-el. The patient was in good health one year after operation. Babes and Nanu (Berliner klin. Woch., No. 7, '97).
The new growth increases in size rapidly, and it may undergo softening at the centre.
The course of the disease is rather rapid, most cases terminating fatally in the course of nine months.
Of benign growths of the bowel ade nomata are the most common. They may be flat or polypoid. They are variable in size, although usually small, soft, and bleeding readily. Sometimes they are firm. Their favorite seat is the rectum. They may, however, be numer ous and widely distributed. Of other non-malignant growths found in the large bowel may be mentioned fibromata, lipomata, papillomata, myxomata, angio mata, and myomata.
Case of lipoma in the descending colon, which had been felt on examination, was finally passed at stool. It was about the size of one's fist, and was attached to the gut by a pedicle; the pedicle was ligated and the tumor removed by a thermocautery, the patient making a perfect recovery. Link (Wiener med. Woch., Mar. 27, '90).