Gastrosplenic fistula due to splenic lymphoma: two case reports and review of the literature

J Med Case Rep. 2024 Mar 7;18(1):136. doi: 10.1186/s13256-024-04441-2.

Abstract

Background: Gastrosplenic fistula is a rare and potentially fatal complication of various conditions. Lymphoma is the most common cause. It can occur spontaneously or after chemotherapy. Gastrosplenic fistula diagnosis can be confused with a splenic abscess because of the presence of air into the mass. The computed tomography identification of the fistulous tract is the key to a right diagnosis. Treatment modalities include surgical resection, chemotherapy, or a combination of both.

Case presentation: Here we report two patients with gastrosplenic fistula due to diffuse large B cell lymphoma. The first patient was a 54-year-old Caucasian woman with an enormous primary splenic diffuse large B cell lymphoma leading to the development of a spontaneous fistula in the stomach. The second patient was a 48-year-old Caucasian male patient with an enormous splenic diffuse large B cell lymphoma complicated by fistula after chemotherapy. Both patients died of septic shock several days after surgery.

Conclusion: Gastrosplenic fistula is a rare complication with a poor-prognosis, for which surgery is currently the preferred treatment.

Keywords: Chemotherapy; Gastrosplenic fistula; Lymphoma; Surgery.

Publication types

  • Review
  • Case Reports

MeSH terms

  • Abdominal Abscess*
  • Confusion
  • Female
  • Fistula*
  • Humans
  • Lymphoma, Large B-Cell, Diffuse* / complications
  • Lymphoma, Large B-Cell, Diffuse* / diagnostic imaging
  • Lymphoma, Large B-Cell, Diffuse* / therapy
  • Male
  • Middle Aged
  • Splenic Diseases* / diagnostic imaging
  • Splenic Diseases* / etiology
  • Splenic Diseases* / therapy