José López-Zamudio1, Luis Ricardo Ramírez-González1, Julia Núñez-Márquez2, Clotilde Fuentes Orozco3, Alejandro González Ojeda3, Karla Lisseth Leonher-Ruezga4. 1. Unidad Médica de Alta Especialidad, Departamento de Cirugía General, Hospital de Especialidades del Centro Médico Nacional de Occidente Instituto Mexicano del Seguro Social (IMSS), Guadalajara, Jalisco, México. 2. Departamento de Patología, Hospital General Regional No. 45. IMSS, Guadalajara, Jalisco, México. 3. Unidad de Investigación en Epidemiología Clínica, Hospital de Especialidades del Centro Médico Nacional de Occidente IMSS, Guadalajara, Jalisco, México. 4. Unidad Médica de Alta Especialidad, Departamento de Cirugía General, Hospital de Especialidades del Centro Médico Nacional de Occidente Instituto Mexicano del Seguro Social (IMSS), Guadalajara, Jalisco, México. Electronic address: karlaleonher@gmail.com.
Abstract
BACKGROUND: Gastric non-Hodgkin lymphoma is a rare tumour that represents approximately 7% of all stomach cancers and 2% of all lymphomas. The most frequent location of gastric MALT (mucosa associated lymphoid tissue) lymphomas is in the antrum in 41% of the cases, and 33% can be multifocal. The risk of spontaneous perforation of a gastric MALT lymphoma is 4-10%. CLINICAL CASE: 24 year old male patient carrying the Human Immunodeficiency Virus, who began with signs and symptoms of acute abdomen and fever 72 hours before arriving in the emergency room. A computed tomography was performed that showed free fluid in the cavity, and gastric wall thickening. The patient underwent a laparotomy, finding absence of the anterior wall of the stomach, sealed with the left lobe of the liver, colon and omentum. Total gastrectomy, with oesophagosty and jejunostomy tube, was performed. CONCLUSIONS: Gastric perforation secondary to a MALT lymphoma is rare, with high mortality. There is limited information reported of this complication and should be highly suspected in order to provide appropriate treatment for a complication of this type.
BACKGROUND: Gastric non-Hodgkin lymphoma is a rare tumour that represents approximately 7% of all stomach cancers and 2% of all lymphomas. The most frequent location of gastric MALT (mucosa associated lymphoid tissue) lymphomas is in the antrum in 41% of the cases, and 33% can be multifocal. The risk of spontaneous perforation of a gastric MALT lymphoma is 4-10%. CLINICAL CASE: 24 year old male patient carrying the Human Immunodeficiency Virus, who began with signs and symptoms of acute abdomen and fever 72 hours before arriving in the emergency room. A computed tomography was performed that showed free fluid in the cavity, and gastric wall thickening. The patient underwent a laparotomy, finding absence of the anterior wall of the stomach, sealed with the left lobe of the liver, colon and omentum. Total gastrectomy, with oesophagosty and jejunostomy tube, was performed. CONCLUSIONS: Gastric perforation secondary to a MALT lymphoma is rare, with high mortality. There is limited information reported of this complication and should be highly suspected in order to provide appropriate treatment for a complication of this type.