Emergency abdominal surgery for complications of metastatic lung carcinoma

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.