A CASE OF JEJUNAL PERFORATION BY A METASTATIC TUMOR FROM GASTRIC CANCER
| Autor: | Atsushi Takimoto, Shinji Togo, Chikara Kunisaki, Kotaro Nagamine, Hiroshi Shimada, Hitoshi Kitamura |
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| Rok vydání: | 1999 |
| Předmět: | |
| Zdroj: | Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association). 60:1005-1008 |
| ISSN: | 1882-5133 1345-2843 |
| DOI: | 10.3919/jjsa.60.1005 |
| Popis: | A rare case of jejunal perforation caused by a metastatic tumor from gastric cancer after subtotal gastrectomy is reported. An 82-year-old man had undergone subtotal gastrectomy for advanced cancer, which penetrated serosa without invasion of adjacent structures with no distant metastasis, with conclusive stage IIIb, resulting in conclusive curability B in September 1992. On October 10, 1994, he was admitted with a chief complaint of abdominal pain. A chest roentgenogram showed free air below the right diaphragm. Although an upper GI series did not reveal a perforated lesion, an emergency operation was performed for the diagnosis of panperitonitis due to bowel perforation. There was a perforated lesion in the jejunum located 35cm distal from the Treitz ligament, and two other tumors were located 62cm and 94cm distal from the Treitz ligament. In the mesenterium, metastatic lymph nodes were swollen like beads but no peritoneal dissemination was found. Partial resection of the jejunum including the perforated lesion and the other two tumors was performed. Histologically, all metastatic tumors showed poorly differentiated adenocarcinoma similar to the primary gastric cancer, and the intramural tumor showed mocosal and serosal layer involvement. It was thought that a metastatic tumor of the small intestine from the primary gastric cancer had caused the jejunal perforation. |
| Databáze: | OpenAIRE |
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