Of the benignant neoplasms the following forms are occasionally met with in the intestine: adenoma, fibroma, lipoma, myoma, angioma, and cyst. These growths are termed polypi if they have a pedicle. Occasionally they have a large base and form only a small prominence over the surface. The polypi are usually of small size, that of a cherry or plum; rarely they are larger, pear-sized or greater still. As a rule they are covered with normal mucous membrane. Although they are found almost everywhere in the intestinal tract, they occur most frequently in the rectum (according to Rosenheim in eighty per cent).

Among the benign tumors the adenomata are most frequently met with. They arise from the mucosa, have a typical acinous structure, and are attached to the mucous membrane either by a broad base or by a pedicle. In the latter instance they form polypoid excrescences which may cover long distances of the intestinal canal, existing in large numbers. Ewald refers to a specimen in his possession in which the inner wall of the colon was covered from the splenic curvature to the sigmoid flexure with such numerous polypi that they projected from the mucous membrane like tassels from a ribbon. The whole specimen looked somewhat like a gigantic bunch of grapes. The polypi are most often met with in children from the fourth to the seventh year, although they also occur in grown-up persons.

1 Madelung: Centralbl. f. Chirurgie, 1892, No. 30.

With regard to symptoms the benign tumors located in the upper parts of the intestinal tract cause hardly any disturbances at all. Sometimes, however, especially if they are present in larger numbers, they may give rise to hemorrhages and catarrhal affections. On account of their small size and soft consistency it is almost impossible to discover them by palpation through the abdominal wall. In very rare instances they may give rise to serious symptoms by occluding the intestinal lumen or by causing invagination. The benign tumors located in the rectum more frequently give rise to disturbances. Thus tenesmus and difficult defecation are often met with; hemorrhages also occur frequently. Sometimes such a polypus, if situated near the anus, may protrude through this opening during defecation and give rise to severe pains. Occasionally a polypus is torn off from the intestinal wall and passed with the stools. In such an event the symptoms, if there have been any, suddenly disappear.

Whenever these tumors are situated in the lower rectum they are accessible to direct examination and treatment. The latter consists in removing them by galvano-cautery or by direct surgical measures.