[原著］肺癌治療中の穿孔性腹膜炎症例の検討

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  • Clinical Study of Perforative peritonitis in Patients with Lung Carcinoma

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In order to elucidate the clinical features of perforative peritonitis in seven patients with lung carcinoma during medication, a retrospective study was undertaken. Perforations were due to peptic ulcer in three patients and metastasis in four patients. There was no significant difference in the clinical stage of the lung carcinoma. It was assumed that the cause of metastatic perforation was chemotherapy or radiotherapy, and that of peptic perforation were drugs in two cases and surgical stress in one case. Metastasis cases tended to show normal values in serum albumin level (3.7g/dl ), WBC count (4633/mm^3), neutrophil count (2581/mm^3), segment ratio (60%), and lymphocyte ratio (31.5%) compared to those of peptic ulcer patients (2.6g/dl, 14367/mm^3, 12663/mm^3, 88.7%, and 4.3%, respectively). All of peptic ulcer cases died after operation within 30 days, while only one of metastasis patients died after operation, showing a better short-term prognosis. In conclusion, patients with lung carcinoma receiving chemotherany, irradiation, NSAIDs (Nonsteroidal anti-inflammatory drugs) and/or sodium succinate should be followed carefully so as not to develop perforation of peptic ulcer and/or gastrointestinal metastasis. In the surgical treatment of patients with lung carcinoma complicated with perforative peritonitis, serum albumin, segment ratio and lymphocyte ratio may be helpful in predicting prognosis.

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