Ganno Hideaki, Nagahama Takeshi, Taira Masahiro, Ohbu Masahide, Ami Katsunori, Ito Tetsushi, Ando Masayuki
Dept. of Surgery, Tokyo Metropolitan Toshima Hospital.
Gan To Kagaku Ryoho. 2007 Nov;34(12):2074-6.
We report a case of perforated metastatic small intestine tumor from the lung. A 56-year-old male admitted for lung cancer with multiple distant metastases developed severe epigastralgia. As radiographic examination revealed free air below diaphragm, we have suspected perforation of upper digestive tract. Exploratory laparoscopy carried out the next day demonstrating perforation of proximal jejunum. Despite jejunal resection, the patient has died of respiratory failure. Pathological evaluation of resected intestine showed a metastatic jejunal tumor with perforation. Metastatic tumor in the digestive tract from lung is a rare condition, and it usually occurs as a part of systemic involvement. To achieve an early diagnosis and treatment, perforation of metastatic tumor should be taken into notice.
我们报告一例来自肺部的转移性小肠肿瘤穿孔病例。一名56岁男性因肺癌伴多发远处转移入院,出现严重上腹部疼痛。由于影像学检查显示膈下有游离气体,我们怀疑上消化道穿孔。次日进行的 exploratory laparoscopy(此处可能有误,推测为“探查性腹腔镜检查”)显示空肠近端穿孔。尽管进行了空肠切除术,患者仍死于呼吸衰竭。切除肠段的病理评估显示为转移性空肠肿瘤伴穿孔。肺部肿瘤转移至消化道是一种罕见情况,通常作为全身受累的一部分出现。为实现早期诊断和治疗,应注意转移性肿瘤的穿孔。