La pathologie et le traitement chirurgical des tumeurs . Fig. 219.—anastomose Intestinale avec l'aide de plaques osseuses perforateddecalcifiées dans le traitement opératoire de l'inoperablecarcinome de l'intestin (après Esmarch) : A, plaques hi situ :B, opération terminée. 336 PATHOLOGIE ET TRAITEMENT DES TUMEURS. Dans de tels cas, comme le bouton serait juste comme Hkely de tomber dans l'angle mort de l'intestin sur le côté proximal de l'obstruction comme dans le côté opposé. En outre, il a été montré par Keen et d'autres thatthe ouverture, petite au début, est susceptible de devenir contractée obéi aux limites de sa requireme

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The pathology and surgical treatment of tumors . Fig. 219.—Intestinal anastomosis with the aid of perforateddecalcified bone-plates in the operative treatment of inoperablecarcinoma of the bowel (after Esmarch) : A, plates hi situ :B, operation completed. 336 PATHOLOGY AND TREATMENT OF TUMORS. in such cases, as the button would be just as Hkely to fall into the blindend of the bowel on the proximal side of the obstruction as into theopposite side. Besides, it has been shown by Keen and others thatthe opening, small in the beginning, is apt to become contracted beyondthe limits of its requirements in a comparatively short time. Rectum.—Carcinoma of the rectum occurs more frequently thancarcinoma of the remaining portion of the intestinal canal, its greaterfrequency here being probably accounted for by the rectum beingmore often the seat of benign growths, of chronic inflammatory affec-tions, and of prolonged irritations from different sources. The histo-logical structure of most of the rectal carcinomata presents a tubular. Fig. 220.—Cylindrical-celled carcinoma of the rectum ; y 4S0 (Surgical Clinic, Rush Medical College, Chicago):a, connective-tissue stroma ; b, atypical tubules of carcinoma; c, cylindrical epithelial cells. arrangement of the cells, surrounded and enclosed by a connective-tissuestroma which in the soft variety of tumors is exceedingly scanty, andin the hard, constricting variety is very abundant and compact (Fig.220). In the rapidly infiltrating form the rectal tube becomes induratedand the surface ulcerates, but its lumen is not much reduced in size.In the circular constricting form the constricting ring is very dense andthe lumen of the bowel is rapidly diminished in size. This is the form CARCINOMA. 337 of rectal carcinoma that produces obstruction and is most favorable tooperative treatment, owing to the limited extent of the tumor and thedilated condition of the bowel above the obstruction, permitting thebowel to be drawn down after rem

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• bookcentury1800
• bookdecade1890
• booksubjectneoplas
• bookyear1895