| Gastrosplenic Fistula Complicated in a Patient with Non- Hodgkin's Lymphoma |
| Seong Eun Yang, Jong Youl Jin, Chi Won Song, Ji Chan Park, Jee In Lee, Wook Kim, Jeana Kim, Hae Giu Lee |
1Department of Internal Medicine, Holy Family Hospital, TheCatholic University of Korea, Seoul, Korea. jyjin@hfh.cuk.ac.kr
2Department of General Surgery, Holy Family Hospital, TheCatholic University of Korea, Seoul, Korea.
3Department of Clinical Patology, Holy Family Hospital, TheCatholic University of Korea, Seoul, Korea.
4Department of Radiology, Holy Family Hospital, The CatholicUniversity of Korea, Seoul, Korea.
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Published online: April 30, 2002. |
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| ABSTRACT |
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Reported cases of gastrosplenic fistulas are extremely rare in the literature. Malignancy is the primary cause in 50% of patients, followed by perforated peptic ulcer (40%).
Fistulas can cause spleen rupture and potential bleeding that threaten the life of the patient. Lymphoma is the most common cause of malignancy complicated with gastrosplenic fistula. Most gastrosplenic fistulae caused by lymphoma eventually close following chemotherapy, although splenectomy should be performed to avoid further complications. We experienced a case of non-Hodgkin's lymphoma complicated with gastrosplenic fistula in a 21 year-old man. He was admitted to our hospital because of LUQ mass. On the abdominal CT, a splenic mass with central necrosis and gas was discovered. The biopsy specimen of the stomach and spleen displayed diffuse, large B cell type non-Hodgkin's lymphoma. After one cycle of CHOP chemotherapy, the LUQ mass was markedly regressed although the gastrosplenic fistula was still present on the follow-up CT. The fistula was treated by splenectomy and a partial resection of gastric fundus. Follow-up chemotherapy was continued after surgery. |
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