Gastrosplenic fistula in Hodgkin's lymphoma treated successfully by laparoscopic surgery and chemotherapy.
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.
Division of Gastroenterology, Department of Medicine, King Faisal Specialist Hospital and Research Centre, PO Box 3354, Riyadh 11211, Kingdom of Saudi Arabia. alashgar@kfshrc.edu.sa
Hamad I
HI
Al-Ashgar
Mohammed Q
MQ
Khan
Abduallah M
AM
Ghamdi
Fahad Y
FY
Bamehriz
Irfan
I
Maghfoor
D000293:Adolescent; D000970:Antineoplastic Agents / Q000627:therapeutic use; D005260:Female; D005747:Gastric Fistula / Q000209:etiology* / Q000628:therapy*; D006689:Hodgkin Disease / Q000150:complications* / Q000188:drug therapy / Q000601:surgery; D006801:Humans; D010535:Laparoscopy; D013158:Splenic Diseases / Q000209:etiology* / Q000628:therapy*
D000970:Antineoplastic Agents