Emergency Operation for Non-Hodgkin Lymphoma of the Small Intestine

We report 5 cases of non-Hodgkin lymphoma of the small intestine (S-NHL)treated with emergency operation.These cases showed three reasons for emergency operation:[1]massive hemorrhage with shock before diagnosis of S-NHL(Case 1),[2]obstruction of the small intestine before and during chemotherapeutic treatment for S-NHL (Cases 2 and 3),and[3]spontaneous perforation with peritonitis before diagnosis of SNHL or iatrogenic perforation following chemotherapy(Cases 4 and 5).For tumor discovery,double-balloon endoscopy of the small intestine was employed in 3 cases.Three tumors were histologically diagnosed before treatment,while 2 were histopathologically diagnosed using the resected specimens after emergency operation. An advanced stage of NHL was frequently observed.No surgical mortality accurred.We always consider the possibility of emergency operation before,during,and after the diagnosis and treatment of patients with SNHL.Shinshu Med J 60 : 21―25, 2012 (Received for publication August 10,2011;accepted in revised form October 7,2011)