Akahoshi K, Chijiiwa Y, Hirota I, Ohogushi O, Motomatsu T, Nawata H, Sasaki I
Department of Internal Medicine, Fukuoka Prefectural Kaho Hospital, Kaho, Japan.
Acta Gastroenterol Belg. 1996 Jul-Sep;59(3):217-9.
A rare case of severe small bowel hemorrhage due to jejunal metastases from a large-cell type carcinoma of the lung is reported. A 69-yr-old Japanese woman presented with complaints of mild abdominal pain and liquid tarry stools 6 months following surgery for lung carcinoma. Gastroduodenoscopy and barium enema yielded unremarkable findings, although a subsequent small bowel enema revealed a large, 15-cm ulcerated mass in the jejunum. This tumor was resected and histology confirmed to be consistent with a metastasis from the primary undifferentiated large-cell carcinoma of the lung. The patient had an uneventful postoperative course and survived for 9 months. There have been only two prior case reports of major intestinal hemorrhage secondary to pulmonary carcinoma metastases in the English literature. Previous reports of such metastases of the small bowel have bowel have documented a very poor prognosis and our patient demonstrated the longest survival period to date. The clinical course of this patient suggests that the early diagnosis and palliative surgery for this complication provide a more favourable outcome.
本文报告了一例罕见的因肺大细胞型癌空肠转移导致严重小肠出血的病例。一名69岁的日本女性在肺癌手术后6个月出现轻度腹痛和柏油样稀便。胃十二指肠镜检查和钡灌肠检查结果均无异常，尽管随后的小肠灌肠显示空肠有一个15厘米的大溃疡肿块。该肿瘤被切除，组织学检查证实与原发性肺未分化大细胞癌转移相符。患者术后恢复顺利，存活了9个月。英文文献中此前仅有两例关于肺癌转移继发大出血的病例报告。此前关于小肠此类转移的报告显示预后非常差，而我们的患者是迄今为止存活期最长的。该患者的临床病程表明，对这种并发症进行早期诊断和姑息性手术可带来更有利的结果。
