Bowel haemorrhage and perforation from metastatic lung cancer. Report of three cases and a review of the literature.

Surgical emergencies caused by bowel metastases from carcinoma of the lung are very rare. A search of the English literature revealed less than 10 cases of bowel perforation and no case of haemorrhage. In this report, we describe three patients with both bowel perforation due to metastases from primary lung tumours (one epidermoid; two adenocarcinoma). In two of these, bleeding occurred several days before perforation, suggesting that bowel haemorrhage may be a warning of impending rupture. It may be reasonable to consider early laparotomy to control haemorrhage and prevent perforation even in such patients despite the presence of disseminated malignant disease.