Abstract
Background. Small bowel metastases from lung cancer are uncommon. Early diagnosis of small bowel metastases is said to be difficult, and the prognosis has been reported to be poor. The recently developed double-balloon enteroscopy (DBE) allows diagnosis and therapeutic interventions in all segments of the small bowel. Cases. We treated 2 cases who were found to have small bowel metastases secondary to lung cancer, using DBE. Case 1 was a 49-year-old man who complained of right chest pain and was given a diagnosis of large cell carcinoma of the lung. He frequently passed black, tarry stools. DBE was done, and histological examination revealed multiple small bowel metastases. The patient died despite aggressive treatment, which included palliative surgical resection (i.e. partial resection) of the small bowel. Case 2 was a 75-year-old man whose chief complaints were general malaise and melena. DBE was done, and histological examination showed multiple small bowel metastases from lung adenocarcinoma. The metastases bled so easily that even temporary hemostasis could not be achieved. Despite repeated red blood cell transfusions, the patient died. Conclusion. DBE is a useful tool for assessing small bowel lesions, because it allows direct observation of the state of small bowel, and it permits a histological diagnosis to be made in a relatively early phase of the disease. However, since DBE can be associated with pain and discomfort, and does not lead to a cure in all patients, candidates for DBE should be assessed for their suitability for the procedure on an individual basis.
