Claros González I, Santonja Garriga J L, Rubio Barbón S, Santamaría Girón L, Triviño López A, Velasco Alvarez A
Hospital Carmen y Severo Ochoa, Cangas del Narcea, Asturias.
Rev Esp Enferm Dig. 1994 Jan;85(1):41-4.
A case of acute abdominal pain due to jejunal perforation in a patient with dissemination of laryngeal carcinoma is presented. Six jejunal intramural nodes of squamous cell carcinoma, one of them perforated, were observed at laparotomy. At the same time, a lesion suspicious of local recurrence in the tracheostomy orifice was observed. The patient died in the postoperative period. The rarity of intestinal perforation as an initial manifestation of metastatical dissemination of a laryngeal squamous cell carcinoma as well as its poor prognosis are discussed. The hematogenous spread is proposed in our case. Finally the inclusion of metastases in the differential diagnosis in a clinical episode of intestinal perforation in patients with a history of neoplasm is emphasized.
本文报告1例喉癌播散患者因空肠穿孔导致急性腹痛的病例。剖腹手术时观察到6个空肠壁内鳞状细胞癌结节，其中1个发生穿孔。同时，在气管造口处观察到1个可疑局部复发的病灶。患者术后死亡。文中讨论了空肠穿孔作为喉鳞状细胞癌转移播散的初始表现的罕见性及其预后不良的情况。我们的病例提示存在血行转移。最后强调，对于有肿瘤病史的患者，在肠道穿孔的临床发作中应将转移瘤纳入鉴别诊断。
