THE SPONTANEOUS PERFORATION RISK OF THE T-CELL LYMPHOMA OF THE SMALL-INTESTINE

Background: A spontaneous perforation in the area of the small intesti ne, in particular of the jejunum, is an absolute rarity. It can occur after a sprue or an unspecific jejunitis or ileitis as well as with le ukaemia, metastases and with a specific illness, the extranodale enter opathy-associated malignant non-Hodgkin's lymphoma of the small intest ine. Patients and Methods: During the period of 12 years a total of 4 patients, whose symptoms and clinical course were typical of this illn ess, were treated in our hospital. In one of the patients a malignant histiocytosis was diagnosed, that corresponds to an outdated definitio n and has to be assigned to the malignant lymphoma as an independent e ntity. The very typical course of a patient's illness is described in detail. Results: All patients showed a typical course of their illness . A prominent feature was the rate of perforation in the area of the s mall intestine, particularly of the jejunum, which was combined with a malabsorption syndrome. Conclusion: A spontaneous perforation of the small intestine leads one to assume that a malignant extranodale non-H odgkin's lymphoma may be present. The preceding clinical results mostl y give the impression of a malabsorption syndrome. The surgical treatm ent is the resection of the perforated part of the small intestine, as the danger of recurrence is very high.