Gastro-splenic fistula, a rare presentation of sickle cell disease patient with splenic abscess: Case report and literature review

Alsinan, Ali; Alelq, Moslem; Alsugair, Fozia; Hassan, Ali; A, Waheed; Alshomimi, Saeed

doi:10.1016/j.ijscr.2019.02.039

Cited by 7 publications

(6 citation statements)

References 12 publications

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“…Hemoglobin S (HbS) levels were reported for 48 cases [ 9 , 11 , 12 , 15 ‐ 17 , 19 ‐ 27 , 29 , 30 , 32 , 33 , 35 , 36 , 38 ‐ 41 , 43 , 46 ‐ 51 , 53 , 54 , 56 ‐ 58 , 62 , 63 ]. The percentage of HbS ranged from 29.8% to 46.5%.…”

Section: Resultsmentioning

confidence: 99%

Splenic infarction in sickle cell trait: A comprehensive systematic review of case studies

Jefferson

Sims

Umeh

et al. 2021

eJHaem

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Sickle cell trait (SCT), a commonly asymptomatic condition, has many associated clinical complications that upon presentation, can be very difficult to attribute to SCT. The effects of SCT on the spleen, for example, are not completely understood, though there have been a number of case reports detailing related complications in diverse populations. Our objective was to perform the first comprehensive case report review of splenic infarction in SCT patients to highlight the relevance of this seemingly rare condition. We conducted an extensive literature search reviewing case reports and case series of acute splenic infarctions from 1970 to 2020. This comprehensive search resulted in 54 articles with a total of 85 individuals. The ages ranged from 7 to 65, 12% were female. Individuals were of African‐American (26%), European (16%), South Asian (13%), Middle Eastern (7%), Latin American (7%), North or East African (4%), Mediterranean (4%), West African (1%), and unknown (22%) origins. Although splenic infarct in SCT patients has been associated with high altitudes, 39% of cases reporting altitude occurred below 3000 m. Among cases where HbS values were recorded, 88% occurred in individuals with HbS levels higher than 35%, suggesting that high HbS values may be a risk factor for splenic infarction. Our findings indicate that splenic infarct occurs across a wide range of demographic populations and environmental settings. While our understanding of SCT evolves, the findings here suggest that future advances in research and healthcare could benefit more from real‐time surveillance and registry initiation for various SCT outcomes such as splenic infarct.

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Section: Resultsmentioning

confidence: 99%

Splenic infarction in sickle cell trait: A comprehensive systematic review of case studies

Jefferson

Sims

Umeh

et al. 2021

eJHaem

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“…Kato et al (26), who focused on the postoperative occurrence of pancreatic fistulas after splenectomy as part of cytoreductive surgery for the treatment of ovarian cancer, reported six pancreatic fistulas in 21 female patients after postoperative day 3, which were detected by elevated amylase levels in the drainage fluid obtained by a surgically placed drain. Moreover, the current literature offers several individual reports of gastrosplenic fistulas occurring in association with splenic abscesses (14)(15)(16)(17)19). Splenocolonic fistulas associated with splenic abscesses have been described before in case reports by McCrystal et al (20), presenting a 16-year-old boy with blunt abdominal trauma and splenic injury, and by Pappalardo et al (22), reporting on a 31-year-old woman with Crohn's disease.…”

Section: Discussionmentioning

confidence: 99%

“…Its application in the therapy of splenic or perisplenic accumulations combined with post-interventional contrast filling can simplify the identification of associated fistulas. The current literature offers almost exclusively individual cases of perisplenic fistulas (14)(15)(16)(17)(18)(19)(20)(21)(22). So far, this is the first trial evaluating the incidence of spontaneous perisplenic fistulas while simultaneously presenting a comparison to reference groups, who had perihepatic and peripancreatic fluid collections, respectively.…”

Section: Discussionmentioning

confidence: 99%

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Occurrence of spontaneous fistulas detected by contrast filling during computed tomography-guided percutaneous drainage placement of splenic and perisplenic fluid collections

et al. 2021

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Background Fistulas are serious complications of splenic and perisplenic fluid accumulations, which are often difficult to detect by routine imaging methods. Purpose To evaluate the occurrence of spontaneous fistulas detectable during computed tomography-guided percutaneous drainage placement (CTGDP) with contrast filling of splenic or perisplenic fluid collections and to assess characteristics in comparison with perihepatic or peripancreatic fluid accumulations, also being treated with CTGDP. Material and Methods In 127 CTGDP-procedures, pre-interventional CTs conducted with intravenous contrast agent were compared to post-interventional CTs including contrast filling of the drain to identify spontaneous fistulas. Patient and case characteristics were evaluated, and therapeutic consequences of fistula identification were analyzed. Results A total of 43 perisplenic, 40 peripancreatic, and 44 perihepatic drains were evaluated; 13 (30.2%) perisplenic, 7 (17.5%) peripancreatic, and 10 (22.7%) perihepatic fistulas were observed. Concerning the frequency of fistulas, no significant difference was found between the patient groups ( P = 0.39). All fistulas were solely proven in CT scans including contrast filling of the drain. Seven fistulas (23.3%) required additional interventions. Perihepatic drains were significantly more often associated with recent surgery ( P < 0.001). The mean size of peripancreatic drains was significantly greater (11.8 ± 3.9 F; P < 0.001) than in perihepatic or perisplenic fluid collections. Conclusion Spontaneous fistulas detected during CTGDP of splenic or perisplenic fluid collections are common. Post-interventional contrast filling of the drain drastically improves the detection rate of perisplenic, peripancreatic and perihepatic fistulas simultaneously initiating appropriate follow-up interventions.

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“…Gastrosplenic fistula is a rare complication of gastric or splenic malignancies or more rarely of benign pathologies such as Crohn's disease, splenic abscess and trauma, melioidosis or sickle cell disease [1][2][3][4][5] . In neoplastic diseases it can occur spontaneously or after chemotherapy, radiation therapy or their combination.…”

Section: Introductionmentioning

confidence: 99%

An Unusual Differential Diagnosis of Gastric Haemorrhage: A Rare Case of Gastrosplenic Fistula

Cicchini

Santarelli

Pugliese

2022

European Journal of Case Reports in Internal Medicine

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A gastrosplenic fistula is a rare complication of primary splenic lymphoma and a rare cause of massive upper gastrointestinal haemorrhage. We report a case of a spontaneous gastrosplenic fistula secondary to splenic large B-cell lymphoma. The patient was admitted to the emergency department with haematemesis. Oesophagogastroduodenoscopy showed a deep gastric ulcer, and a subsequent CT scan revealed a gastrosplenic fistula. Gastric biopsy demonstrated gastric mucosa with infiltration by large lymphoid cells. A multidisciplinary discussion on the management of this case was conducted. Primary surgical treatment of the fistula was not deemed indicated because the bleeding had stopped. The patient was stabilized, transfused, and then transferred to the oncology unit for chemotherapy. During hospitalization, lung metastases were found but the progressive worsening of the patient’s general condition contraindicated chemotherapy. She was transferred to a hospice and died 2 months later of neoplastic cachexia. Gastrosplenic fistula is a rare condition. Prompt recognition of the underlying pathology can save the patient’s life. We aim to highlight this rare complication of splenic lymphoma, discuss the presenting signs and symptoms, and explore the management options.

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Gastro-splenic fistula, a rare presentation of sickle cell disease patient with splenic abscess: Case report and literature review

Cited by 7 publications

References 12 publications

Splenic infarction in sickle cell trait: A comprehensive systematic review of case studies

Splenic infarction in sickle cell trait: A comprehensive systematic review of case studies

Occurrence of spontaneous fistulas detected by contrast filling during computed tomography-guided percutaneous drainage placement of splenic and perisplenic fluid collections

An Unusual Differential Diagnosis of Gastric Haemorrhage: A Rare Case of Gastrosplenic Fistula

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