Shi Rui-Xian, Guo Zhen-Ping, Li Xin, Wang Hui, Wang Bo, Du Ming-Yue, Wang Ji-Jun, Dong Zhen-Yu
Department of Neurology, Baotou Central Hospital, Baotou 014040, Inner Mongolia Autonomous Region, China.
Department of Neurology, Inner Mongolia Medical University, Hohhot 010080, Inner Mongolia Autonomous Region, China.
World J Gastrointest Surg. 2025 May 27;17(5):104049. doi: 10.4240/wjgs.v17.i5.104049.
The clinical metastasis rate of lung cancer is tremendously low in gastrointestinal tract. Individuals enduring small intestine metastasis of lung cancer are normally featured by less desirable prognosis and shorter survival than those with metastasis in other parts of the body. As a consequence, it holds crucial significance to conduct early diagnosis and development of systematic treatment for patients with gastrointestinal metastasis in lung cancer.
In this case, a 59-year-old female patient, diagnosed with lung adenocarcinoma, experienced intestinal obstruction attributable to subsequent small intestinal metastasis. Imaging confirmed the metastasis to the small intestine after the adenocarcinoma diagnosis, ultimately giving rise to advanced-stage intestinal obstruction. Conservative treatment proved ineffective, progressing to intestinal perforation in the later stages. This resulted in peritonitis and infectious toxic shock and other serious clinical manifestations. Aggressive surgical resection mitigated the risk of disease progression and even fatality, which tremendously ameliorated the patient's prognosis and prolonged her survival.
Patients enduring lung cancer who exhibit acute abdominal symptoms should be mindful of the potential for small intestinal metastasis. Intestinal perforation typically occurs in advanced stages of the disease. Moreover, and aggressive surgical treatment can mitigate the risk of multifarious complications such as peritonitis, infectious toxic shock, and even fatality.
肺癌在胃肠道的临床转移率极低。与肺癌转移至身体其他部位的患者相比,发生小肠转移的患者通常预后较差,生存期较短。因此,对肺癌发生胃肠道转移的患者进行早期诊断并制定系统治疗方案具有至关重要的意义。
本病例中,一名59岁女性患者被诊断为肺腺癌,随后因小肠转移出现肠梗阻。影像学检查证实腺癌诊断后发生小肠转移,最终导致晚期肠梗阻。保守治疗无效,后期发展为肠穿孔。这导致了腹膜炎和感染性中毒性休克等严重临床表现。积极的手术切除降低了疾病进展甚至死亡的风险,极大地改善了患者的预后并延长了生存期。
出现急性腹部症状的肺癌患者应警惕小肠转移的可能性。肠穿孔通常发生在疾病晚期。此外,积极的手术治疗可降低腹膜炎、感染性中毒性休克甚至死亡等多种并发症的风险。