Gastrosplenic fistula

A gastrosplenic fistula is a very rare type of gut fistulation that can occur as a complication with either a gastric or splenic lesion.

Pathology

Etiology

Recognized causes include

• lymphoma (considered commonest cause)

  • most commonly diffuse large B-cell lymphoma (DLBCL)

    • usually in context of chemotherapy

    • rarely reported spontaneously

• gastric adenocarcinoma ²

• Crohn’s disease

• splenic abscess

• trauma

Often requires extensive splenic necrosis and gastric wall infiltration (usually in the case of lymphoma) for gastrosplenic fistula formation. It may occur after chemotherapy as a result of rapid regression of tumor that has initially infiltrated the gastric mucosa.

Treatment and prognosis

Prognosis can be variable. Surgical resection is performed for many cases.