A Case of Intussusception due to Metastatic Jejunal Tumor of Lung Cancer

Takahito Nakagawa¹⁾²⁾, Nobuhisa Nakajima¹⁾²⁾, Yuuichi Shinoda²⁾, Ryuunosuke Niinuma²⁾, Yoshie Une¹⁾, Junichi Uchino¹⁾

¹⁾First Department of Surgery, Hokkaido University School of Medcine , ²⁾Department of Surgery, Furano Kyokai Hospital

A 69-year-old man was admitted with upper abdominal pain and vomiting. Contrast X-ray examination of the small intestine using an intestinal tube, and CT scan suggested the presence of intussusception on the upper jejunum. Emergency laparotomy was performed. On exploration of the peritoneal cavity, three hard masses were noted in the jejunum about 40 cm distal from the ligament of Treitz. The mesenteric lymph nodes were swollen. Multiple metastatic lesions were also noted on both lobes of the liver. One of the jejunal tumors was the cause of intussusception. The involved jejunum was resected along with the jejunal masses. Histopathologically, the tumor cells were of the undifferentiated type, growing mainly at the submucosal region of the jejunum. These findings characterized the metastatic nature of the tumors. Postoperative radiological examination of the chest revealed the pulmonary mass, 2 cm in diamter, in the right S6, with mediastinal lymph node involvement. Cytologic examination of sputum showed malignant cells. In view of these data, the lung cancer was considered to be primary, with the jejunal tumors with hepatic and mesenteric involvement being secondary.

Key words
intussusception, metastatic jejunal tumor, lung cancer

Reprint requests
Takahito Nakagawa First Department of Surgery, Hokkaido University School of Medicine
N15 W7, Kita-ku, Sapporo, 060 JAPAN

Accepted
December 8, 1993

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