Rothermel Luke D, Chadwick Cathryn L, Thambi-Pillai Thavam
Department of Surgery, Wright State University Boonshoft School of Medicine, Dayton, Ohio 45409, USA.
Int Surg. 2010 Jul-Sep;95(3):270-2.
A gastrosplenic fistula is a rare event. Reported causes include a spontaneous malignant fistula, chemotherapy for gastric or splenic malignancies, peptic ulcer disease, Crohn disease, and trauma. We report a case of a gastrosplenic fistula discovered on abdominal computed tomography with contrast, performed in a patient with a history suspicious for malignancy. In this case, no etiology was identified prior to the surgical repair of the lesion despite extensive workup. Due to continued gastrointestinal blood loss requiring multiple transfusions, the patient was taken to surgery for splenectomy and partial gastrectomy. It was at that time that the diagnosis of a large B-cell lymphoma was made. Postoperative chemotherapy was initiated and led to remission of the malignancy. Though most cases require definitive surgical repair, the treatment plans for gastrosplenic fistulas depend largely on the etiology of the lesion.
胃脾瘘是一种罕见的病症。报告的病因包括自发性恶性瘘、胃或脾恶性肿瘤的化疗、消化性溃疡病、克罗恩病以及外伤。我们报告一例在腹部增强计算机断层扫描时发现的胃脾瘘病例，该患者有恶性肿瘤可疑病史。在这个病例中，尽管进行了广泛的检查，但在对病变进行手术修复之前未确定病因。由于持续的胃肠道失血需要多次输血，患者接受了脾切除术和部分胃切除术。就在那时确诊为大B细胞淋巴瘤。术后开始化疗，使恶性肿瘤得到缓解。虽然大多数病例需要进行确定性的手术修复，但胃脾瘘的治疗方案在很大程度上取决于病变的病因。
