A Case of Gastric Hemorrhage Due to Gastrosplenic Fistula Caused by Chemotherapy for Splenic Malignant Lymphoma

DOI Web Site

Bibliographic Information

Other Title
  • 化学療法が著効して形成された胃脾瘻孔を介して消化管出血をきたした脾原発悪性リンパ腫の1例
  • カガク リョウホウ ガ チョコウシテ ケイセイ サレタ イヒロウコウ オ カイシテ ショウカカン シュッケツ オ キタシタ ヒゲンパツ アクセイ リンパシュ ノ 1レイ

Search this article

Abstract

<p>An 87-year-old woman was referred to our hospital due to dyspnea on exertion, and computed tomography (CT) indicated a mass lesion measuring 13 cm in diameter extending from the spleen to the stomach. Upper gastrointestinal tract endoscopy showed a large submucosal tumor at the greater curvature in the middle-third of the stomach. Biopsy of the lesion revealed diffuse large B-cell lymphoma. Chemotherapy was started, which resulted in shrinkage of the tumor, but the patient vomited blood on day 51 after the start of chemotherapy, and developed hemorrhagic shock. Findings of abdominal CT led to the suspicion of gastrointestinal bleeding due to rupture of malignant lymphoma into the stomach. Endoscopic hemostasis was attempted, but failed because the gastrosplenic fistula was too large. Therefore, emergency laparotomy was performed. Intraoperatively, the stomach was found to be filled with clotting blood, but no intraabdominal bleeding was observed. After cutting the splenic hilum to control the bleeding, the infiltrated stomach was partially resected and the specimen was removed. The postoperative course was satisfactory. Histopathology showed that the tumors of the spleen and stomach wall were completely necrotic, suggesting that the chemotherapy was effective.</p>

Journal

Keywords

Details 詳細情報について

Report a problem

Back to top