Spontaneous Gastrosplenic Fistula Resulting From Primary Gastric Lymphoma: Case Report And Review Of The Literature (original) (raw)
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Spontaneous gastrosplenic fistula secondary to primary splenic lymphoma
Case Reports, 2010
A gastrosplenic fistula is a rare complication of gastric and splenic lymphomas which can occur spontaneously or secondary to chemotherapy. We report a case of a spontaneous gastrosplenic fistula secondary to a diffuse splenic large B cell lymphoma in a previously well 43-year-old patient. CT imaging demonstrated the fistula, which was subsequently managed with chemotherapy. The clinical management of this rare condition is discussed with a review of the literature.
Gastrosplenic fistula due to splenic lymphoma: Two case reports and literature Review
Background: Gastrosplenic fistula (GSF) is a rare and potentially fatal complication of various diseases. Lymphoma is the most common cause. It can occur spontaneously or after chemotherapy. This rare entity may be misdiagnosed. Treatment modalities include surgical resection, chemotherapy or a combination of both. Actually, more and more are headed towards a chemotherapy regimen only to treat GSF.Case presentation: Here we report two cases of GSF due to diffuse large B cell lymphoma patients. First case is of a 54-year-old woman with a primary enormous spleen diffuse large B cell lymphoma (DLBCL) leading to a spontaneous fistula in the stomach. The second one is of a 48 year-old-male patient with a primary spleen DLBCL which fistula complicating chemotherapy. The evolution was fatal for both of them after undergoing surgeryConclusions: GSF complicating lymphomas is a rare disease entity, our case report and a systematic review of the literature may help physicians to diagnose and t...
Gastro-Splenic Fistula Related to Large B Cell Lymphoma
Reports — Medical Cases, Images, and Videos
We report a case of spontaneous gastrosplenic fistula in a 57 year old female who presented to the emergency department with abdominal pain and weight loss. From the physical examination, she had a palpable abdominal mass. A CT scan was performed and showed a mass involving the proximal greater curve of the stomach, infiltrating the spleen and pancreas. There was a 12 mm defect in the cardia of the stomach with gas entering the large mass but there was no free gas in the abdomen. The defect was a gastrosplenic fistula. A gastroscopic biopsy confirmed the diagnosis of diffuse large B cell lymphoma. Surgical removal of the mass was not feasible; therefore she was treated with RCHOP chemotherapy, achieving complete remission.
Gastrosplenic fistula following successful chemotherapy for disseminated histiocytic lymphoma
Cancer, 1983
A case is presented of a patient with diffuse histiocytic lymphoma with splenic involvement who developed a communication between the greater gastric curvature and the splenic parenchyma after successful antineoplastic chemotherapy. This fistula was diagnosed by CT scan and confirmed by upper gastrointestinal barium series and fiberoptic endoscopy. This complication was managed successfully by an enbloc resection of the greater curvature of the stomach, splenectomy, and distal pancreatectomy. Histologic assessment of the stomach and spleen failed to reveal residual tumor. The clinical evolution of this rare complication is discussed and the literature on this subject is reviewed. Cancer 52:994-996. 1983. IRECT COMMUNICATION between two abdominal D viscera is usually the result of congenital, traumatic, inflammatory, neoplastic or iatrogenic processes' affecting one or both organs. Fistula formation is a rare complication of primary and secondary lymphomas of the gastrointestinal t r a~t ,~.~ although it is apparent that secondary involvement of intraabdominal viscera leads to a higher incidence of fistula f~r m a t i o n .~.~ Among the different histologic types, histiocytic lymphoma appears to have a greater propensity to produce perforation or fistula f~r m a t i o n .~.~ Although spontaneous fistualization may occur, the successful treatment of lymphoma by radiation the rap^,^ ~hemotherapy~,~ or has led to the development of this unusual complication. We report a case of diffuse histiocytic lymphoma with splenic involvement complicated by a fistulous tract between the stomach and the spleen during effective chemotherapy and successful surgery. This interesting course of events has not been reported previously.
Saudi medical journal, 2007
A gastrosplenic fistula is a rare complication of a gastric or splenic lesion. We report a case of Hodgkin's lymphoma nodular sclerosis involving the spleen that was complicated by spontaneous gastrosplenic fistula. The fistula was closed laparoscopically, and the patient underwent partial gastrectomy and gastric wall repair, followed by successful chemotherapy. This is also the first reported case in published literature where closure of gastrosplenic fistula and partial gastrectomy was carried out laparoscopically. We recommend that extensive open surgical procedures including total gastrectomy, splenectomy, and pancreatectomy may be avoided in the management of gastrosplenic fistula, and the patient could be managed by less radical, simple laparoscopic fistulectomy, with partial gastric resection. If the fistula is caused by a malignant process, the surgical repair should be followed by definitive treatment with chemotherapy and radiotherapy.
Annals of medicine and surgery (2012), 2018
A gastrosplenic fistula (GSF) is a very rare complication that arises mainly from a splenic or gastric large cell lymphoma. The proximity of the gastric fundus to the enlarged fragile spleen may facilitate the fistulisation. This complication can lead to massive bleeding, which, though uncommon, may be lethal. We present a patient with massive upper gastrointestinal bleeding secondary to a GSF. We present a 48-year-old man with a refractory diffuse large B-cell lymphoma who was admitted to our hospital due to hematemesis. On arrival, he was in hemorrhagic shock, and was taken directly to the intensive care unit. The source of bleeding could not be identified on gastroscopy, the patient remained hemodynamically unstable and a laparotomy was performed.A fistula between a branch of the splenic artery and the stomach was identified. The stomach appeared to be involved in the malignant process. After subtotal gastrectomy and splenectomy, the bleeding was controlled. After stabilization, ...
An Atypical Case of Primary Gastric Lymphoma
Scholars Journal of Medical Case Reports, 2016
We report a case of a fifty-two-year old gentleman who presented with a history of early satiety after meals altered bowel habits for 1 month and fever for 2 weeks. On local examination, an intra-abdominal, non-tender, variegated swelling was found extending from left hypochondrium to the epigastric region. Contrast enhanced CT scan showed a heterogeneous mass (11 cm x 11 cm) at left upper quadrant, medial to spleen, compressing the stomach, ?Neoplastic lesion. Exploratory laparotomy found a huge irregular mass involving spleen, tail of pancreas, gerota's fascia and greater curvature of stomach, having adhesion with diaphragm and omentum, but without any enlarged lymph nodes. En-bloc excision of mass along with spleen, tail of pancreas, and a sleeve of stomach including the greater curvature was preformed. Subsequently, histopathology and immunohistochemistry confirmed it to be a case of Diffuse Large B-Cell Lymphoma of stomach (DLBCL).The rarity of the diagnosis along with its nature of presentation, and absence of several characteristic features make this case an interesting one.
Ileo-Colonic Fistula Due to Diffuse Large B Cell Lymphoma: Unusual Presentation of a Rare Disease
Cureus, 2021
Malignant ileocolonic fistulas have seldom been documented as complications of a primary gastrointestinal lymphoma (PGIL) such as aggressive diffuse large B cell lymphoma (DLBCL). These fistulas are frequently misdiagnosed due to the nonspecific clinical presentation. Currently, there is no standardized treatment approach, although a couple have been suggested with varying outcomes. We describe a case of DLBCL complicated with a malignant ileocolonic fistula in a 55-year-old male with a favorable outcome after surgery and chemotherapy.