M Sousa1, A Gomes2, N Pignatelli3, V Nunes4. 1. B Surgery Department, Hospital Prof. Dr. Fernando Fonseca, EPE, 2720-276 Amadora, Portugal. Electronic address: martadavidsousa@gmail.com. 2. B Surgery Department, Hospital Prof. Dr. Fernando Fonseca, EPE, 2720-276 Amadora, Portugal. Electronic address: apspgomes@gmail.com. 3. B Surgery Department, Hospital Prof. Dr. Fernando Fonseca, EPE, 2720-276 Amadora, Portugal. Electronic address: nbpignatelli@gmail.com. 4. B Surgery Department, Hospital Prof. Dr. Fernando Fonseca, EPE, 2720-276 Amadora, Portugal. Electronic address: nunesvt@gmail.com.
Abstract
INTRODUCTION: Gastrosplenic fistula (GSF) is a rare condition almost always associated with lymphoma, with gastric and splenic involvement. CASE REPORT: We report a 52 year old male with gastric lymphoma admitted to the emergency department with hematemesis. The first chemotherapy cycle had been completed four weeks before. Oesophagoduodenoscopy showed a pulsatile ulcerated lesion. Surgical hemostasis was performed. Four days after surgery, the patient initiated sudden and massive upper gastrointestinal bleeding with hemodynamic compromise. A gastrosplenic fistula was recognized during emergency laparotomy and an en bloc total gastrectomy and splenopancreatectomy resection was performed, with massive blood transfusion. Patient was discharged 13 days after the second surgery. DISCUSSION: Gastrosplenic fistula is a rare condition, previously described associated with gastric lymphoma at presentation or after treatment. A prompt recognition of the underlying pathology could avoid a second surgery. CONCLUSION: A systematic and interdisciplinary approach is the key for success in rare challenging emergencies. Infrequent etiologies must always be considered as they need specific therapeutic approaches that defy paradigms.
INTRODUCTION:Gastrosplenic fistula (GSF) is a rare condition almost always associated with lymphoma, with gastric and splenic involvement. CASE REPORT: We report a 52 year old male with gastric lymphoma admitted to the emergency department with hematemesis. The first chemotherapy cycle had been completed four weeks before. Oesophagoduodenoscopy showed a pulsatile ulcerated lesion. Surgical hemostasis was performed. Four days after surgery, the patient initiated sudden and massive upper gastrointestinal bleeding with hemodynamic compromise. A gastrosplenic fistula was recognized during emergency laparotomy and an en bloc total gastrectomy and splenopancreatectomy resection was performed, with massive blood transfusion. Patient was discharged 13 days after the second surgery. DISCUSSION: Gastrosplenic fistula is a rare condition, previously described associated with gastric lymphoma at presentation or after treatment. A prompt recognition of the underlying pathology could avoid a second surgery. CONCLUSION: A systematic and interdisciplinary approach is the key for success in rare challenging emergencies. Infrequent etiologies must always be considered as they need specific therapeutic approaches that defy paradigms.
Authors: Oscar Campuzano; Olallo Sanchez-Molero; Anna Fernandez; Irene Mademont-Soler; Monica Coll; Alexandra Perez-Serra; Jesus Mates; Bernat Del Olmo; Ferran Pico; Laia Nogue-Navarro; Georgia Sarquella-Brugada; Anna Iglesias; Sergi Cesar; Esther Carro; Juan Carlos Borondo; Josep Brugada; Josep Castellà; Jordi Medallo; Ramon Brugada Journal: Sports Med Date: 2017-10 Impact factor: 11.136
Authors: Amit Frenkel; Yoav Bichovsky; Zvi H Perry; Jochanan Peiser; Aviel Roy-Shapira; Evgeni Brotfain; Leonid Koyfman; Yair Binyamin; Karen Nalbandyan; Moti Klein Journal: Ann Med Surg (Lond) Date: 2018-03-31