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[转移性肺癌导致肠穿孔:一例报告]

[Bowel perforation due to metastatic lung cancer: a case report].

作者信息

Aoyama Kazutoshi, Hiyama Junichiro, Horita Naokatsu, Shiota Yutaro, Ono Tetsuya, Yamakido Michiro

机构信息

Department of Internal Medicine, Kure Kyosai Hospital, 2-3-28 Nishichuo, Kure, Hiroshima, 737-8505, Japan.

出版信息

Nihon Kokyuki Gakkai Zasshi. 2003 Aug;41(8):537-40.

Abstract

We report a case of small bowel perforation secondary to metastasis from a lung squamous cell carcinoma that occurred in a 72-year-old man. He was admitted to the hospital because of remittant hemoptysis after undergoing a right upper lobectomy. Fiberoptic bronchoscopy revealed bleeding from the right upper lobe bronchial stump that was due to recurrence of the tumor. He developed abdominal pain, nausea and vomiting four months after resection of the primary tumor. An abdominal radiograph demonstrated free air in the abdominal cavity. He was diagnosed as having intestinal perforation and was operated on. The operative findings indicated adherence and perforation of the jejunum and ileum. The pathological diagnosis of the removed tumor was poorly differentiated squamous cell carcinoma. The patient died 32 days after the second operation. Although abdominal metastasis from lung cancer is not an unusual postmortem finding, it is rare in clinical situations. If a patient with lung cancer complains of abdominal pain, it is important to consider the possibility of abdominal metastasis.

摘要

我们报告一例72岁男性因肺鳞状细胞癌转移继发小肠穿孔的病例。他因右上肺叶切除术后反复咯血入院。纤维支气管镜检查显示右上叶支气管残端出血,系肿瘤复发所致。在原发肿瘤切除四个月后,他出现腹痛、恶心和呕吐。腹部X线片显示腹腔内有游离气体。他被诊断为肠穿孔并接受了手术。手术所见为空肠和回肠粘连并穿孔。切除肿瘤的病理诊断为低分化鳞状细胞癌。患者在第二次手术后32天死亡。虽然肺癌腹部转移在尸检中并非罕见发现,但在临床情况下却很少见。如果肺癌患者主诉腹痛,考虑腹部转移的可能性很重要。

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