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Spntaneous perforation of the gastrointestinal tract in patients with cancer.

The mortality of spontaneous gastrointestinal perforation in 36 patients with cancer was 84% (30 patients). The main factors responsible for this included failure of recognition, perforation through tumor, advanced uncontrolled disease and multiple organ failure. Six of 19 patients who underwent surgery survived (32%). Five of these patients did not perforate through tumor and their underlying malignancy was in good control. Earlier diagnosis is essential. Prompt surgical intervention and intensive supportive measures are indicated only if additional therapy of the underlying malignancy offers a reasonable chance for continued worthwhile palliation.