Abstract
A 72-year-old woman who had been staying at the department of respiratory surgery in our hospital for the treatment of lung cancer had vomiting, and a protrusion in the femoral area was confirmed. With a diagnosis of incarceration of femoral hernia, a radical operation was performed. On the next day, a right upper lobectomy was performed for lung cancer. Histopathologically, poorly differentiated adenocarcinoma with large cell carcinoma was demonstated. Postoperative course was uneventful. However, vomiting occurred again on the 8th day after the lobectomy. Abdominal x-ray film revealed air-fluid level and intestinal obstruction was diagnosed.
Fluoloscopy of the small intestine through an ileus tube revealed a stenosis 30cm distal to the Treitz' ligament. CT scan and echography showed layered intraperitoneal structure. From these findings, intussusception due to small bowel metastasis of the lung cancer was suspected, and a laparotomy was performed. At laparotomy, the jejunum developing intussusception 30cm distal to the Treitz' ligament which formed an infant's fist-sized tumor was confirmed. So a partial resection of the small intestine was performed. A 5.0×4.5cm tumor of the small intestine was noted. It was histopathologically metastasis to the small intestine from the lung cancer.
