Abstract
A case of small bowel perforation due to the disseminated tumor from the pancreatic cancer was reported.
A 75-year-old male was transferred to our surgical department with the diagnosis of refractory intestinal obstruction.
His abdominal X-ray film just after complaining of disastrous abdominal pain showed free air in the abdominal cavity.
On emergent celiotomy, there were numerous disseminated peritoneal nodules, a great deal of purulent fluids and a thumb-tip sized metastatic tumor of the small intestine causing small bowel perporation. Then, resection of small intestine including the perforation area and the metastatic tumor was performed.
Intraoperative palpation revealed a hard mass in the pancreatic body.
Postoperative diagnostic imaging (CT-MRI) also demonstrated pancreatic body tumor.
These findings led to the diagnosis that primary lesion was the pancreatic cancer and the metastatic tumor of the small intestine from the pancreatic cancer caused small bowel perforation.
The prognosis of a patient with small bowel perforation due to the disseminated tumor from the cancer originating from intraabdominal organ like pancreatic cancer is poor.
However, surgical intervention for perforative peritonitis is significant enough because it can make the patient's sufferings chiefly pain free and it enables the patient's peroral intake.
