A Case of the Small Bowel Perforation due to the Metastasis of the Lung Cancer

Michiya Kobayashi, Takuro Ogata, Keijiro Araki, Kimio Matsuura, Akira Kaneko, Masanori Sugito, Hiraku Yamamoto, Atsunori Takeshita*

First Department of Surgery, Kochi Medical School, Takeshita Hospital*

We experienced a case of small bowel perforation due to lung cancer metastasis. A 73-year-old man was transferred to our hospital with the diagnosis of acute abdomen. An abdominal X-ray demonstrated free air in the abdominal cavity. The case was diagnosed panperitonitis due to intestinal perforation. Emergency laparotomy was performed and the perforated jejunum was resected. Histological examination revealed malignant cells, but the histological type could not be determined. A chest X-ray showed a coin lesion in the lower lung field of the left lung, from which the lung cancer was suspected. Segmentectomy of the left lung was performed and histological findings revealed a poorly differentiated adenocarcinoma, which was the same finding as in the perforated jejunum. After chemotherapy, another perforation occurred and the perforated ileum was resected. We could not find the cancer cells in the perforated site. Chemotherapy and radiotherapy were performed for bone metastasis and mediastinal lymph node metastasis. The prognosis for a patient with perforation of the small intestine due to lung cancer metastasis is poor. Our patient died 2 years and 10 months after the first operation.

Key words
lung cancer, metastatic tumor of the small intestine, perforation of the metastatic lung cancer of the intestine

Reprint requests
Michiya Kobayashi First Department of Surgery, Kochi Medical School
Kohasu Oko-cho, Nankoku, 783 JAPAN

Accepted
November 11, 1992

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