Emergency abdominal surgery for complications of metastatic lung carcinoma
J. M. Woods 4th and M. J. Koretz
Department of Surgery, Emory University School of Medicine, Atlanta, Ga.
Acute intra-abdominal conditions due to metastatic primary lung cancer have
been reported rarely in the literature, with a very high associated
operative mortality noted. We report on 13 patients with metastatic lung
cancer who underwent exploratory celiotomy from 1976 through 1988. Twelve
were men, and their ages ranged from 43 to 68 years. All but 1 of the
patients had known extra-abdominal metastases (primarily brain) at the time
of the abdominal symptoms. In 11 patients the small bowel was the site of
metastases. One patient had cecal involvement, while the 13th had common
bile duct obstruction. The most common histologic type was a large-cell
carcinoma. The extent of surgery was dependent on the pathologic findings
encountered; most patients underwent resection of obstructed or perforated
intestine. Eight of the 13 patients survived and were discharged from the
hospital after a mean stay of 17 days. We conclude that acute
intra-abdominal conditions from metastatic lung cancer can often be treated
successfully by prompt surgical exploration, including bowel resection or
bypass if necessary.
