Colosplenic fistula presentation in the context of undiagnosed colon cancer: Case report and review of literature

Ashouri, Mohammad; Kuhi, Zahra; Ataie-Ashtiani, Zahra; Mohammadzadeh, Narjes

doi:10.1016/j.ijscr.2022.106828

Cited by 4 publications

(2 citation statements)

References 12 publications

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“…Pathological examination of the colon and the spleen in this case revealed acute inflammatory changes and perforation adjacent to the splenic lesion, without evidence of malignancy or inflammatory bowel disease. This finding is consistent with the literature, which reports various causes for colosplenic fistulae, including inflammatory diseases, trauma, and complications from previous medical interventions [12][13][14][15][16][17][18][19]. In a recent case series and literature review, the predominant etiologies were colonic lymphoma (30%) and colorectal carcinoma (17%) [19].…”

Section: Discussionsupporting

confidence: 90%

Colosplenic Fistula Following Splenic Embolization in a Sickle Cell Disease Patient

Al Jabri,

Al Masrouri,

Al Adawi

et al. 2024

Cureus

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This case report details a rare instance of a colosplenic fistula following splenic embolization in a patient with sickle cell disease. The patient, a 29-year-old female, presented with symptoms of left hypochondrial pain and fever. Imaging revealed a splenic abscess characterized by an air-fluid level. Intraoperative observations disclosed that the spleen was entirely replaced by an abscess cavity, with the presence of colosplenic fistulae. A splenectomy and colonic resection were performed. This report highlights a rare complication that occurred a long time after splenic embolization, underscoring the need for a high level of suspicion to prevent serious complications.

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Section: Discussionsupporting

confidence: 90%

Colosplenic Fistula Following Splenic Embolization in a Sickle Cell Disease Patient

Al Jabri,

Al Masrouri,

Al Adawi

et al. 2024

Cureus

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“…Fistulas are usually the result of intra-abdominal inflammation or infection or the consequence of malignant disease, or they develop as a complication of abdominal surgery or trauma. Our search of the literature led to the finding of a previous report of colonic fistula formation, a gastrocolic fistula ( 15 ), and, subsequently, two more recent cases of fistula connecting the colon and spleen ( 16 , 17 ). Many studies documented the tendency of the colon to fistulize to contiguous organs, such as the bladder (colovesical fistula), vagina (colovaginal fistula), and intestinal loops (coloenteric fistula).…”

Section: Discussionmentioning

confidence: 99%

Splenocolic fistula in a patient with diffuse large B-cell lymphoma: A case report and review of literature

Luca

Sergi²,

Coco

et al. 2022

Front. Surg.

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A fistula that connects the bowel to other organs, such as the urinary bladder or small intestine, is a relatively frequent complication, often associated with inflammatory diseases such as diverticulitis, Crohn's disease, colorectal cancer, or lymphoma. Splenocolic fistula is an extremely rare condition described in the literature. It can occur in cases of splenic tumors, including splenic diffuse large B cell lymphoma. We report the case of an 82-year-old man who presented with melaena, worsening asthenia, hypotension, and abdominal pain in the left flank and the ipsilateral lumbar region. Ultrasound and computed tomography documented splenomegaly, thickening of the splenic flexure of the colon, and the presence of a fistulous passage between the colon and the splenic hilum. The diagnosis of lymphoma was made following laparotomy and caudal splenopancreatectomy. Due to the aggressive clinical behavior of this type of lymphoma, splenectomy is the main treatment in patients with splenomegaly, abdominal pain, and tumor expansion.

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Colosplenic fistula diagnosis and management: a case series and review of literature

Hernandez Dominguez,

Lincango,

Spivak

et al. 2024

International Journal of Surgery

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Background: A colosplenic fistula (CsF) is an extremely rare complication. Its diagnosis and management remain poorly understood, owing to its infrequent incidence. Our objective was to systematically review the etiology, clinical features, diagnosis, management, and prognosis to help clinicians gain a better understanding of this unusual complication and provide aid if it is to be encountered. Methods: A systematic review of studies reporting CsF diagnosis in Ovid MEDLINE, Ovid EMBASE, Scopus, Web of Science, and Wiley Cochrane Library from 1946 to June 2022. Additionally, a retrospective review of four cases at our institution were included. Cases were evaluated for patient characteristics (age, sex, and comorbidities), CsF characteristics including causes, symptoms at presentation, diagnosis approach, management approach, pathology findings, intraoperative complications, postoperative complications, 30-day mortality, and prognosis were collected. Results: Thirty patients with CsFs were analyzed, including four cases at our institution and 26 single-case reports. Most of the patients were male (70%), with a median age of 56 years. The most common etiologies were colonic lymphoma (30%) and colorectal carcinoma (17%). Computed tomography (CT) was commonly used for diagnosis (90%). Approximately 87% of patients underwent a surgical intervention, most commonly segmental resection (81%) of the affected colon and splenectomy (77%). Nineteen patients were initially managed surgically, and 12 patients were initially managed nonoperatively. However, 11 of the nonoperative patients ultimately required surgery due to unresolved symptoms. The rate of postoperative complications was (17%). Symptoms resolved with surgical intervention in 25 (83%) patients. Only one patient (3%) had had postoperative mortality. Conclusions: Our review of 30 cases worldwide is the largest in literature. CsFs are predominantly complications of neoplastic processes. CsF may be successfully and safely treated with splenectomy and resection of the affected colon, with a low rate of postoperative complications.

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Colosplenic fistula presentation in the context of undiagnosed colon cancer: Case report and review of literature

Cited by 4 publications

References 12 publications

Colosplenic Fistula Following Splenic Embolization in a Sickle Cell Disease Patient

Colosplenic Fistula Following Splenic Embolization in a Sickle Cell Disease Patient

Splenocolic fistula in a patient with diffuse large B-cell lymphoma: A case report and review of literature

Colosplenic fistula diagnosis and management: a case series and review of literature

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