about 50% of patients with a diagnosis of non - small cell lung carcinoma exhibit metastatic disease at the time of diagnosis . the preferential sites of extrapulmonary spread are the lymph nodes , liver , brain , adrenal glands , and bones . a 51-year - old smoker was diagnosed with a poorly differentiated non - small cell lung carcinoma of the right lower lobe in stage ct2a he received front - line therapy with cisplatin - pemetrexed . a ct scan after 4 cycles revealed a partial response in the lung and a complete response in the brain . after 2 cycles , locoregional progression was observed , with the extrapulmonary disease still controlled . after 2 cycles , the patient complained of abdominal pain and reported melena , yet without signs of intestinal obstruction . biological data revealed severe aregenerative anaemia ( haemoglobin concentration at 6.9 g / dl , reticulocyte count at 120,000/mm ) and iron deficiency signs consisting of low serum ferritin , iron , and transferrin saturation . the stool examination for occult blood was strongly positive , while gastric fiberscopy and colonoscopy results were normal . abdominal ct with contrast medium enhancement showed an intussusception of the small bowel ( fig 1 ) . we then decided to explore the small bowel by means of capsule endoscopy , which revealed several secondary lesions , including one stenosing the first jejunal loop and another one ulcerated and bleeding ( fig 2 ; online suppl . videos 1 and 2 ; for all online suppl . a double - balloon enteroscopy was performed thereafter for lesion biopsy , confirming the metastatic localisation of a poorly differentiated lung carcinoma . on account of the patient 's poor performance status , surgical treatment was not considered , with only symptomatic treatment performed using several blood transfusions and iron supplementation . at last , the patient died 20 months following the cancer diagnosis and 5 months after discovering the intestinal metastasis . improvement in metastatic lung cancer management has led to extending survival , and we are thus faced with an increasing number of uncommon metastatic sites . gastrointestinal metastases are considered to be rare , usually occurring in advanced disease stages , and associated with poor prognosis . due to their mostly asymptomatic presentation , were observed in 12% of patients , with the small bowel as the most common site of metastatic involvement . gastric and duodenal metastases likely cause abdominal pain , haematemesis , as well as chronic bleeding resulting in anaemia . small bowel involvement often leads to acute abdomen , and may be associated with various clinical complications such as perforation , obstruction , or haemorrhage . clinical cases of gastrointestinal metastases from lung cancer have been reported , with diagnosis systematically delayed . as illustrated in our case report , although conventional imaging revealed jejunal intussusception , the correct diagnosis of metastatic intestinal involvement was only brought upon by capsule endoscopy . this non - invasive procedure thus represents a valuable method contributing to a rapid and detailed diagnosis while reducing underdiagnosis . this strategy allows for obtaining a therapeutic effect in patients with solitary gastrointestinal metastases , and a favourable palliative effect on survival in those with preoperatively diagnosed metastases . we reported a case of small bowel metastases from primary lung cancer revealed by abdominal pain and severe recurrent anaemia . capsule endoscopy allowed for an aetiologic diagnosis to be obtained , and should thus be considered in lung cancer patients complaining of abdominal symptoms , which may indeed be related to gastrointestinal metastases . written informed consent was obtained from the patient for publication of this case report and any accompanying images .