Gastric Necrosis After an Infarction of the Spleen: Report of a Case

Abstract

Gastric necrosis is a rare and often fatal condition. A few reports of gastric necrosis of various etiologies have been published in the literature. This report deals with a case in which gastric necrosis and perforation occurred several years after an infarction of the spleen. Preoperative computed tomography showed the existence of splenic vein thrombosis accompanying splenic infarction. A laparotomy revealed an 8-cm-long laceration with ragged margins in the posterior of the stomach along the greater curvature. Furthermore, massive venous thrombosis was found in the major omentum. As a result, the reduced arterial blood supply and insufficient venous drainage due to splenic venous thrombosis may have together played a major role in the development of gastric necrosis.

Possible cause underlying gastric necrosis and perforation: Celiac artery thrombosis

“…On the other hand, gastric necrosis may be a life-threatening condition due to increased perforation risk [4]. Its etiology includes cardiovascular disease, hypercoagulable state, arterial thrombosis and embolism, hemodynamic compromise, hypoxemia, alcohol ingestion, corrosive substance intake, gastric outlet obstruction, gastric herniation, massive gastric dilatation, volvulus, previous gastric surgery, bulimia, trauma and infection [4][5][6][7]. Based on the information gleaned from the patient's evaluation, the most likely diagnosis is stomach necrosis and perforation due to celiac artery thrombosis.…”

Synchronous Adenocarcinoma and Gastrointestinal Stromal Tumor of the Stomach Treated by a Combination of Laparoscopy-assisted Distal Gastrectomy and Wedge Resection

“…By contrast, these complications occurred in only 23% of cases in which the left gastric artery had been ligated. Portal hypertension(14) and splenic venous thrombosis(15) (one cause of gastric necrosis) have also been found to impede gastric venous drainage. However, one report found that a single short gastric artery can supply the entire stomach adequately via its intramural vessel connections.…”