Massive gastrointestinal bleeding after chemotherapy for gastric lymphoma
Autor(a) principal: | |
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Data de Publicação: | 2016 |
Outros Autores: | , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://hdl.handle.net/10400.10/1587 |
Resumo: | INTRODUCTION: Gastrosplenic fistula (GSF) is a rare condition almost always associated with lymphoma, with gastric and splenic involvement. CASE REPORT: We report a 52 year old male with gastric lymphoma admitted to the emergency department with hematemesis. The first chemotherapy cycle had been completed four weeks before. Oesophagoduodenoscopy showed a pulsatile ulcerated lesion. Surgical hemostasis was performed. Four days after surgery, the patient initiated sudden and massive upper gastrointestinal bleeding with hemodynamic compromise. A gastrosplenic fistula was recognized during emergency laparotomy and an en bloc total gastrectomy and splenopancreatectomy resection was performed, with massive blood transfusion. Patient was discharged 13 days after the second surgery. DISCUSSION: Gastrosplenic fistula is a rare condition, previously described associated with gastric lymphoma at presentation or after treatment. A prompt recognition of the underlying pathology could avoid a second surgery. CONCLUSION: A systematic and interdisciplinary approach is the key for success in rare challenging emergencies. Infrequent etiologies must always be considered as they need specific therapeutic approaches that defy paradigms. |
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Massive gastrointestinal bleeding after chemotherapy for gastric lymphomaEmergency surgeryGastric fistulaLymphomaCirurgia de emergênciaFístula gástricaLinfomaINTRODUCTION: Gastrosplenic fistula (GSF) is a rare condition almost always associated with lymphoma, with gastric and splenic involvement. CASE REPORT: We report a 52 year old male with gastric lymphoma admitted to the emergency department with hematemesis. The first chemotherapy cycle had been completed four weeks before. Oesophagoduodenoscopy showed a pulsatile ulcerated lesion. Surgical hemostasis was performed. Four days after surgery, the patient initiated sudden and massive upper gastrointestinal bleeding with hemodynamic compromise. A gastrosplenic fistula was recognized during emergency laparotomy and an en bloc total gastrectomy and splenopancreatectomy resection was performed, with massive blood transfusion. Patient was discharged 13 days after the second surgery. DISCUSSION: Gastrosplenic fistula is a rare condition, previously described associated with gastric lymphoma at presentation or after treatment. A prompt recognition of the underlying pathology could avoid a second surgery. CONCLUSION: A systematic and interdisciplinary approach is the key for success in rare challenging emergencies. Infrequent etiologies must always be considered as they need specific therapeutic approaches that defy paradigms.ElsevierRepositório do Hospital Prof. Doutor Fernando FonsecaSousa, MGomes, APignatelli, NNunes, V2016-03-28T11:44:09Z2016-01-01T00:00:00Z2016-01-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10400.10/1587engInt J Surg Case Rep. 2016 Feb 20;21:41-432210-261210.1016/j.ijscr.2016.02.017info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2022-09-20T15:52:20ZPortal AgregadorONG |
dc.title.none.fl_str_mv |
Massive gastrointestinal bleeding after chemotherapy for gastric lymphoma |
title |
Massive gastrointestinal bleeding after chemotherapy for gastric lymphoma |
spellingShingle |
Massive gastrointestinal bleeding after chemotherapy for gastric lymphoma Sousa, M Emergency surgery Gastric fistula Lymphoma Cirurgia de emergência Fístula gástrica Linfoma |
title_short |
Massive gastrointestinal bleeding after chemotherapy for gastric lymphoma |
title_full |
Massive gastrointestinal bleeding after chemotherapy for gastric lymphoma |
title_fullStr |
Massive gastrointestinal bleeding after chemotherapy for gastric lymphoma |
title_full_unstemmed |
Massive gastrointestinal bleeding after chemotherapy for gastric lymphoma |
title_sort |
Massive gastrointestinal bleeding after chemotherapy for gastric lymphoma |
author |
Sousa, M |
author_facet |
Sousa, M Gomes, A Pignatelli, N Nunes, V |
author_role |
author |
author2 |
Gomes, A Pignatelli, N Nunes, V |
author2_role |
author author author |
dc.contributor.none.fl_str_mv |
Repositório do Hospital Prof. Doutor Fernando Fonseca |
dc.contributor.author.fl_str_mv |
Sousa, M Gomes, A Pignatelli, N Nunes, V |
dc.subject.por.fl_str_mv |
Emergency surgery Gastric fistula Lymphoma Cirurgia de emergência Fístula gástrica Linfoma |
topic |
Emergency surgery Gastric fistula Lymphoma Cirurgia de emergência Fístula gástrica Linfoma |
description |
INTRODUCTION: Gastrosplenic fistula (GSF) is a rare condition almost always associated with lymphoma, with gastric and splenic involvement. CASE REPORT: We report a 52 year old male with gastric lymphoma admitted to the emergency department with hematemesis. The first chemotherapy cycle had been completed four weeks before. Oesophagoduodenoscopy showed a pulsatile ulcerated lesion. Surgical hemostasis was performed. Four days after surgery, the patient initiated sudden and massive upper gastrointestinal bleeding with hemodynamic compromise. A gastrosplenic fistula was recognized during emergency laparotomy and an en bloc total gastrectomy and splenopancreatectomy resection was performed, with massive blood transfusion. Patient was discharged 13 days after the second surgery. DISCUSSION: Gastrosplenic fistula is a rare condition, previously described associated with gastric lymphoma at presentation or after treatment. A prompt recognition of the underlying pathology could avoid a second surgery. CONCLUSION: A systematic and interdisciplinary approach is the key for success in rare challenging emergencies. Infrequent etiologies must always be considered as they need specific therapeutic approaches that defy paradigms. |
publishDate |
2016 |
dc.date.none.fl_str_mv |
2016-03-28T11:44:09Z 2016-01-01T00:00:00Z 2016-01-01T00:00:00Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/10400.10/1587 |
url |
http://hdl.handle.net/10400.10/1587 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
Int J Surg Case Rep. 2016 Feb 20;21:41-43 2210-2612 10.1016/j.ijscr.2016.02.017 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Elsevier |
publisher.none.fl_str_mv |
Elsevier |
dc.source.none.fl_str_mv |
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
instname_str |
Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
instacron_str |
RCAAP |
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RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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1777301453465976832 |