Small bowel perforation with multiple intestinal metastases from lung carcinoma: A case report

Misiakos,Evangelos  P.; Gouloumi,Alina‑Roxani; Schizas,Dimitrios; Damaskou,Vasileia; Tsapralis,Dimitrios; Farrugia,Frederick‑Anthony; Machairas,Nikolaos; Papaconstantinou,Dimitrios; Tzaneti,Ariadni; Machairas,Anastasios

doi:10.3892/ol.2019.10031

Small bowel perforation with multiple intestinal metastases from lung carcinoma: A case report

Authors:
- Evangelos P. Misiakos
- Alina‑Roxani Gouloumi
- Dimitrios Schizas
- Vasileia Damaskou
- Dimitrios Tsapralis
- Frederick‑Anthony Farrugia
- Nikolaos Machairas
- Dimitrios Papaconstantinou
- Ariadni Tzaneti
- Anastasios Machairas
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Affiliations: 3rd Department of Surgery, National and Kapodistrian University of Athens, School of Medicine, Attikon Hospital, Athens 12462, Greece, 2nd Department of Pathology, National and Kapodistrian University of Athens, School of Medicine, Attikon Hospital, Athens 12462, Greece, 1st Department of Surgery, National and Kapodistrian University of Athens, School of Medicine, Laiko Hospital, Athens 11527, Greece, Department of General Surgery, General Hospital/Health Center of Ierapetra, Crete 77200, Greece
Published online on: February 12, 2019 https://doi.org/10.3892/ol.2019.10031
Pages: 3862-3866
Copyright: © Misiakos et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

The present report describes the case of an 81‑year‑old woman who underwent an emergency explorative laparotomy due to small bowel perforation. Diffuse feculent peritonitis due to perforation of the jejunum was identified. In addition, six distinct tumors of the jejunum in close proximity to the perforation site, as well as two more lesions caudally at the ileum, were identified. A separate stenotic tumor was identified at the sigmoid colon, causing moderate dilatation of the whole intestine. An enterectomy, including the perforation site and the proximal six tumors, was performed, followed by limited enterectomies for the distal two tumors and side‑to‑side anastomoses of the small intestine. All resected tumors were identified at histology as metastatic from lung carcinoma. Postoperatively, the patient remained in a severe septic condition and succumbed the following day. Metastatic lesions from lung carcinoma in the small bowel wall are a rare finding predisposing to bowel perforation. When an acute condition coexists with multiple intestinal metastases, the mortality rate is high despite prompt surgical intervention.

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