Yamada Chizu, Nitta Hiroshi, Ishikawa Fumihiko, Fujita Yoshihisa, Omoto Hideyuki, Kamata Shigeyuki, Miyauchi Youhei, Morinaka Takashi, Ito Hiroshi
Dept. of Surgery, Fukaya Red Cross Hospital.
Gan To Kagaku Ryoho. 2017 Nov;44(12):1176-1178.
We here describe a case of an acute peritonitis due to perforation of a small intestine tumor metastasized from a lung cancer. A 66-year-old man who had undergone a bladder cancer procedure 2 years ago and was hospitalized for the second operation, complained sudden abdominal pain. An enhanced abdominal CTrevealed a small amount of free gas and ascites in the abdominal cavity. On the same day, emergency exploratory surgery was performed with the diagnosis of perforative peritonitis. A laparotomy revealed a jejunal tumor with perforation 40 cm distal from the Treitz ligament. After surgery, the patient confessed that he had got a notice of the recurrence of lung cancer which had been treated 9 years ago. The pathological result indicated the lesion was metastasis from lung cancer. Although small intestinal metastatic tumor from lung cancer is rare, it should be considered when acute abdomen is observed.
我们在此描述一例因肺癌转移至小肠导致穿孔引发急性腹膜炎的病例。一名66岁男性,2年前接受过膀胱癌手术,此次因第二次手术入院,主诉突发腹痛。腹部增强CT显示腹腔内有少量游离气体和腹水。同一天,诊断为穿孔性腹膜炎后进行了急诊探查手术。剖腹手术发现距Treitz韧带40 cm处的空肠肿瘤伴穿孔。术后,患者承认收到了9年前已治疗的肺癌复发通知。病理结果表明该病变为肺癌转移。尽管肺癌小肠转移瘤罕见,但在观察到急腹症时应予以考虑。