Abstract
We devised a method of the colonoscopy carried out by injecting indigocarmin into the mesenteric artery and it was used in one case of the villous tumor and two cases of the colon carcinoma. In villous tumor of 9 cm in diameter observed in the sigmoid colon, the tumor was stained deep blue uniformly and disappearance of the dye was simultaneous and rapid. This case was shown histologically to be papillary adenoma. In one case of carcinoma of the descending colon, the tumor was stained blue irregularly, disappearance of the dye was delayed and in a part of the tumor, it was seen stained blue for a long time. This was considered to be due to extravasation of the dye owing to increased vacular permeability on the lesion and may be corresponding to the findings called tumor blush, tumor stain or increased contrast accumula-tion in the angiography. In another case of carcinoma observed on rectosigmoid region, the tumor was not stained at all and delayed disappearance of the dye was noted in thr surrounding normal colonic wall suggesting an intense degree of vascular invasion of the tumor. In this case, liver metastasis and carcinomatous peritoneal dissemination were found at the time of operation and resection of the lesion was impracticable. Thus, it is made possible by this method (1) differentia-tion of the protruding lesion whether it is benign or malignant, (2) diagnosis of the depth of carcinoma of the large intestine to a certain extent, and (3) estimation of the degree of vascular invasion, helping determination of prognosis. This method is considered to be significant as a sup-plementary diagnostic method which extends the range of possible diagnosis of ordinary endoscopy and angiography.
