TWO SURGICAL CASES OF PERFORATING PERITONITIS DUE TO METASTASIS OF LUNG CANCER TO THE SMALL INTESTINE

Two cases of perforating peritonitis due to metastasis of lung cancer to the small intestine which were surgically treated are reported. Case 1: A 63-year-old man was pointed our abnormal chest shadow at a medical checkup, and was diagnosed as having cancer of the right upper lobe of the lung with infiltration into the trachea and esophagus and metastases to the adrenal gland and brain. While he was followed up without any treatments in the outpatient clinic, abdominal pain abruptly occurred 3 months after the first visit. Emergency operation was performed with a diagnosis of perforating peritonitis. The patient was discharged from the hospital on the 25th day, but died on the 35th day after the operation. Case 2: A 73-year-old man was diagnosed as having right lung cancer, pleural effusion, and brain metastasis. While he received radiation therapy for the brain metastasis, abdominal pain abruptly occurred one month after admission and an emergency operation was performed. He was able to eat after the operation, however, he died of cancer on the 25th hospital day. Perforation due to metastasis of lung cancer to the small intestine has poor prognosis because it often occurs in the course of terminal stage. We think that surgical treatment should be performed by considering the patient's general condition, because it can offer an improvement in the QOL for the patient even though it is temporal.