Inflammatory complications of cancer of the caecum and ascending colon.

There occurs in the right lower abdomen a wide variety of pathological lesions many of which present clinically as a lump. Chief among them are carcinoma and the 'appendix mass' or the appendix abscess. Recent experience has brought home to me how confused the diagnosis may be between these two; for not only may they be very much alike when presenting alone, but still more perplexing is the occurrence of the two together, as is so often the case. Clinicians of riper experience than mine will doubtless number in recollection many patients presenting, in their management, just the problems which I shall presently describe. It is also true that there have been several contributions on this aspect of caecal cancer in the literature of the past 20 years or so (Wakeley and Rutherford, 1932; Bartlett and Miller, I940; Mayo, 1941; Brown, Colvert and Brush, I948). My only excuse in' rediscovering' what is already known to a few, is the somewhat disturbing lack of awareness (or so at least it seems to me) of the high incidence of the inflammatory complications of right colon cancer, a deficiency which many of the standard textbooks of surgery do little or nothing to make good.