Perforation Peritonitis Secondary to Small Intestinal Metastasis from Pleomorphic Lung Cancer：A Case Report

Abstract

A 64-year-old man visited our hospital for evaluation of lumbago. He was diagnosed as having a vertebral metastasis from primary lung cancer and underwent instrumented spinal stabilization. He developed abdominal distention and bilious vomiting 2 days after the surgery. He was diagnosed as having paralytic ileus and initiated on conservative treatment; however, this treatment was ineffective, and he was transferred to our department 5 days later. Computed tomography revealed a large amount of intraperitoneal free air. He was diagnosed as having panperitonitis due to gastrointestinal perforation and underwent emergency laparotomy. Intraoperatively, we detected jejunal perforation and significant mesenteric lymphadenopathy; therefore, small bowel resection was performed followed by reconstruction with end-to-end anastomosis, peritoneal lavage, and drainage. Histopathological examination of the resected specimen revealed small intestinal metastasis from pleomorphic lung cancer. The patient was transferred to the Department of Internal Medicine on the 18th postoperative day, and subsequent evaluation revealed multiple distant metastases from lung cancer. He wished to receive only supportive care and died on the 64th postoperative day.