A Case of Small Bowel Obstruction Secondary to Intraluminal Metastasis from an Undiagnosed Metastatic Lung Cancer

Abstract

Background: Small bowel obstruction is a common emergency general surgical presentation with multiple possible causes. Small bowel metastases from a primary lung cancer is unusual with one study showing only 0.9% of patients with primary lung cancer will have metastasis to the small bowel.Methods: We present a case of a 66-year-old fit male who was admitted at the Accident and Emergency Department unwell and septic with clinical and radiological findings of small bowel obstruction.Results: The patient resuscitated and brought to operation theatres despite no obvious cause of the obstruction in the Computerised Tomography (CT) scan of the abdomen and pelvis. Laparotomy revealed small bowel obstruction secondary to an intraluminal small bowel lesion. Post-operative CT scan chest and histopathology of the excised lesion showed metastatic adenocarcinoma of the small bowel from a newly diagnosed lung cancer. Post operatively, patient initially recovered well but he deteriorated rapidly due to hospital acquired pneumonia and passed away 15 days after initial presentation.Conclusion: The case highlights the need to be cognizant of rarer causes of common emergency general surgical complaints.