Vasireddy Ramya, Bilalaga Mariah M, Gaddipati Greeshma, Chen Terina S, Gurm Hashroop
Department of Internal Medicine, MedStar Union Memorial Hospital, Baltimore, MD, USA.
Department of Pathology, MedStar Franklin Square Hospital, Baltimore, MD, USA.
J Community Hosp Intern Med Perspect. 2025 May 5;15(3):98-102. doi: 10.55729/2000-9666.1487. eCollection 2025.
Lung cancer is often diagnosed at advanced stages frequently metastasizing to organs like the liver, adrenal glands, brain and bones. However, gastrointestinal metastasis, especially to the small intestine, is rare. We report a patient who presented with a perforated small bowel, requiring emergent laparotomy. Imaging suggested an infectious process, but subsequent workup revealed jejunal perforation and poorly differentiated lung cancer. Despite being a candidate for immunotherapy alone, the patient opted for hospice. This case emphasizes the atypical presentation of lung cancer as a gastrointestinal complication and underscores the importance of keeping malignancy in the differential for a perforated small bowel.
肺癌常常在晚期才被诊断出来，且 frequently metastasizing to organs like the liver, adrenal glands, brain and bones（经常转移至肝脏、肾上腺、脑和骨骼等器官）。然而，胃肠道转移，尤其是转移至小肠的情况较为罕见。我们报告了一名出现小肠穿孔、需要紧急剖腹手术的患者。影像学检查提示为感染性病变，但后续检查发现是空肠穿孔和低分化肺癌。尽管该患者仅为免疫治疗的候选对象，但患者选择了临终关怀。本病例强调了肺癌作为胃肠道并发症的非典型表现，并突出了在鉴别小肠穿孔时考虑恶性肿瘤的重要性。
