Identifier: diseasesofrectum00gant (find matches)
Title: Diseases of the rectum and anus: designed for students and practitioners of medicine
Year: 1910 (1910s)
Authors: Gant, Samuel Goodwin, 1869?-
Subjects: Anus Diseases Rectal Diseases
Publisher: Philadelphia : F. A. Davis
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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n shape, and their surfaces rough-ened by deep, puncJied-out, crater-like ulcerations. This con-dition is characteristic of this form of the disease and imparts tothe touch a sensation not likely to be forgotten. Furthermore,the growth may be felt as a flat, indurated, band-like constric-tion encircling the bowel, in many cases producing completeocclusion (carcinoma retrahens). This latter form of rectalcancer is not infrequently mistaken for syphilitic stricture. Itshould be remembered, however, that a rectal ulceration pro-longed for several years antedates S5^philitic stenosis, whileannular carcinoma of the rectum produces an equally tightstricture within a few weeks or months, and, moreover, is fre-quently characterized by secondary metastasis (especially in theliver), cachexia, emaciation, and immobility of the rectum, dueto the involvement of adjacent structures. Cancerous neoplasms have sometimes been confused withcoccygeal, pelvic, vesical, uterine, and vaginal tumors; vesical
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6s as 2^ H a MALIGNANT TUMORS 531 calculi; chronic enlargement of the prostate; inflammatorydeposits due to blind fistulous sinuses, and fecal impaction.Again, simple adenomata, lipomata, fibromata, and ulceratedor indurated hemorrhoids have been diagnosticated as cancer.Of these latter affections, adenomata or polyps are the mostfrequently confused with carcinoma, because they often attainconsiderable size, may be soft or hard, become ulcerated andbleed more or less, and when multiple are usually accompaniedby a profuse discharge of pus and blood. Clinically, polyps are dilTerentiated from cancer by the factthat they occur in young subjects, are pedunculated and fre-quently protrude, have a non-indurated base, and do not in-volve the perirectal structures or attack neighboring organs orproduce cachexia or metastasis. It is well to remember, how-ever, that adenomata which have remained innocent for 3^earsmay become transformed into malignant adenomata as a resultof irritation or other

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