The Diagnosis of Carcinoma of the Right Colon *

Adequate surgery performed in an early stage of the disease offers the best chance for cure in carcinoma of the right colon. It is generally agreed that right colectomy is the preferred method of treatment under these circumstances. This operation can be utilized with a reasonable risk, particularly if the resection is performed precisely in one stage with immediate anastomosis by suture (Harvey,4 Harvey and Connor5). Adequate surgery is often delayed because the manifestations of the disease in its early stages may be too subtle to suggest the proper diagnosis. A clear conception of those signs and symptoms upon which a working diagnosis of carcinoma of the right colon can be made is therefore essential, if the advantages of adequate surgery are to be realized. fully. The anatomical and physiological features of the right colon differ sharply from those of the distal colon; similarly, the symp-tomatology of carcinoma of the right colon differs from that of carcinoma of the distal colon. It is pertinent, therefore, to consider those dinical features which should suggest the possibility of car-cinoma of the proximal colon, and which are useful in establishing the proper working diagnosis. The present report deals with an analysis of the important diagnostic data in 50 cases of carcinoma of the right colon, observed on the Surgical Service of the New Haven Hospital. All of the patients in the series were operated upon. In 44 cases (88 per cent) the tumor was removed and a pathological diagnosis of carcinoma was made. In 6 cases (12 per cent) the tumor was judged to be non-resectalble; in 2 of these cases autopsy revealed the disease to be carcinoma, in the 4 remaining cases the gross pathology observed at operation was typical of carcinoma. Age and Sex. The distribution of the cases with respect to age and to sex is shown in Table 1. The majority of cases occurred in the so-called "cancer age group." That carcinoma of the right colon may be a disease of youth is emphasized by the 2 cases under 30 years of age, and by an incidence of 12 per cent in the age group under 40 years. This is in essential agreement with the findings