Jejunal Perforation by Metastasis of Malignant Pleural Mesothelioma

Our plain-English summary of Jejunal Perforation by Metastasis of Malignant Pleural Mesothelioma, by M.I. Navarro García, A. Sánchez Pérez, J.L. Vázquez Rojas (Archivos de Bronconeumología, 2015).

The study

• Authors: M.I. Navarro García, A. Sánchez Pérez, J.L. Vázquez Rojas
• Journal: Archivos de Bronconeumología
• Published: 2015;51(7):366-7
• Type of article: Case report, Letter
• Language: Spanish
• Cited by: 6 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Summary of the article

This letter to the editor, written in Spanish by surgeons in Cartagena, Murcia, Spain, reported a case of jejunal perforation caused by metastasis of malignant pleural mesothelioma. The authors noted that asbestos is the main factor implicated in this tumour, which usually stays local in the affected side of the chest; metastatic disease is uncommon and gastrointestinal complications from metastases are rare. The patient was a 67-year-old man who had undergone radical pleuropneumonectomy with lymphadenectomy in July 2010 for malignant pleural mesothelioma (T3N2M0), followed by adjuvant chemotherapy. In August 2011 he came to the emergency department with sudden abdominal pain of 4 hours' duration and signs of peritoneal irritation. Laboratory tests were normal. Abdominal CT showed pneumoperitoneum and wall thickening of a short segment of jejunum. Emergency surgery found acute purulent peritonitis from a single jejunal perforation over an ischaemic plaque. The bowel segment was resected and rejoined. Pathology showed metastasis of epithelioid malignant mesothelioma in the bowel wall and in 2 lymph nodes. Recovery was satisfactory and chemotherapy was started. A Medline review (1974-2013) found 4 reported cases with small-bowel involvement and one earlier case presenting as acute jejunal perforation, making this the second acute presentation. The authors concluded that small-bowel metastasis should be considered in patients with a history of this cancer who have acute abdominal pain, occult blood in the stool or intermittent, non-specific abdominal pain.

PubMed has no abstract for this study, and the article doesn't print one. We wrote this summary from the full article with the help of AI. It is not the authors' wording.

In plain English

This Spanish-language letter to the editor, by authors from the surgery department of Hospital General Universitario Santa Lucía in Cartagena, Spain, described one patient. The patient was a 67-year-old man with malignant pleural mesothelioma (stage T3N2M0). He had the pleura and lung removed, with lymph nodes, in July 2010, followed by chemotherapy. In August 2011 he came to the emergency department with sudden abdominal pain of 4 hours. A CT scan showed air in the abdomen and a thickened short segment of jejunum (small intestine). Emergency surgery found peritonitis from a single hole in the jejunum, and that piece of bowel was removed. Tissue examination found epithelioid malignant mesothelioma that had spread to the bowel wall and to 2 lymph nodes. Searching Medline (1974 to 2013), the authors described this as the second reported case presenting as acute jejunal perforation. The authors concluded that small-bowel spread should be considered in patients with this history who have acute abdominal pain, hidden blood in the stool, or intermittent, nonspecific abdominal pain. The article did not report the patient's asbestos exposure.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Case report (letter to the editor) with a brief literature search
• Who was studied: One 67-year-old man with malignant pleural mesothelioma (T3N2M0), operated on in July 2010 (radical pleuropneumonectomy with lymphadenectomy). The authors are from the general and digestive surgery department of Hospital General Universitario Santa Lucía, Cartagena, Murcia, Spain. The article does not explicitly state where the patient was treated.
• Exposure: Not reported for this patient. The article mentions asbestos only as background: it is the main factor involved in causing malignant pleural mesothelioma in general.
• Main results:
  • In August 2011 the patient came to the emergency department with sudden abdominal pain of 4 hours' duration
  • Abdominal CT showed pneumoperitoneum (air in the abdomen) and circumferential wall thickening of a short segment of small intestine (jejunum)
  • Emergency surgery found purulent peritonitis from a single jejunal perforation on an ischemic plaque. The affected bowel was removed.
  • Pathology showed metastasis of epithelioid malignant mesothelioma in the intestinal wall and in 2 isolated lymph nodes
  • The postoperative course was satisfactory, and the patient was referred to oncology for chemotherapy
  • The authors' Medline search (1974 to 2013) found 4 described cases of malignant pleural mesothelioma metastasis involving the small intestine and one case presenting as acute jejunal perforation. They described their patient as the second case with acute presentation.
• The authors' conclusion: The authors concluded that small-bowel metastasis should be considered in patients with a history of malignant pleural mesothelioma who have acute abdominal pain, occult blood in the stool, or intermittent nonspecific abdominal pain

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer, Mesothelioma.

Medical terms in this study, explained in our Lexicon: Metastasis, Pleural Mesothelioma, Chemotherapy, Pathology, Epithelioid, Mesothelioma.

Related studies

• Malignant pleural mesothelioma presenting as an acute surgical abdomen due to metastatic jejunal perforation — K. Gocho, K. Isobe, et al. (2010)
• Solitary malignant mesothelioma of the small intestine: radiological appearances — N. Gourtsoyiannis, D. Bays, et al. (1996)
• Incidental mesonephric remnant hyperplasia of the jejunal mesentery: A diagnostic challenge — J.F. Val-Bernal, M.M. Mayorga, et al. (2021)
• Synchronous Jejunal Sarcomatoid Carcinoma and Incidentally Associated Localized Peritoneal Malignant Mesothelioma — M. Tachibana, M. Nozawa, et al. (2022)
• Left diaphragmatic hernia complicated by perforation of an intrathoracic gastric ulcer into the aorta: report of a case — Y. Saito, Y. Yamakawa, et al. (2000)
• Spontaneous urinary bladder perforation: An unusual presentation of well-differentiated papillary peritoneum mesothelioma — A. Serao, F. Ambrosini, et al. (2022)

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