Gastric necrosis and perforation as a complication of splenectomy. Case report and related references
Necrosis of the stomach after isolated splenectomy with the formation of gastrocutaneous fistula is a rare event that occurs in less than 1% of splenectomies. It is more frequent when the removal of the spleen is done because of hematological diseases. Its mortality index can reach 60% and its patho...
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| Format: | Article |
| Language: | English |
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Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia (IBEPEGE)
2000-10-01
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| Series: | Arquivos de Gastroenterologia |
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-28032000000400008&tlng=en |
| _version_ | 1798020183492657152 |
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| author | Carlos Augusto Real MARTINEZ Jaques WAISBERG Rogério Tadeu PALMA Sansom Henrique BROMBERG Mário Augusto Padula CASTRO Paulo Amaral dos SANTOS |
| author_facet | Carlos Augusto Real MARTINEZ Jaques WAISBERG Rogério Tadeu PALMA Sansom Henrique BROMBERG Mário Augusto Padula CASTRO Paulo Amaral dos SANTOS |
| author_sort | Carlos Augusto Real MARTINEZ |
| collection | DOAJ |
| description | Necrosis of the stomach after isolated splenectomy with the formation of gastrocutaneous fistula is a rare event that occurs in less than 1% of splenectomies. It is more frequent when the removal of the spleen is done because of hematological diseases. Its mortality index can reach 60% and its pathogenesis is controversial, as it may be attributed both to direct trauma of the gastric wall and to ischemic phenomena. Although the stomach may exhibit exuberant arterial blood irrigation, anatomical variations can cause a predisposition towards the appearance of potentially ischemic areas, especially after ligation of the short gastric vessels around the major curvature of the stomach. Once this is diagnosed in the immediate postoperative period, it becomes imperative to reoperate. The surgical procedure will depend on the conditions of the peritoneal cavity and patient's clinic status. The objective of this study was to report on the case of a patient submitted to splenectomy because of closed abdominal traumatism, who then presented peritonitis and percutaneous gastric fistula in the post-operative period. During the second operation, perforations were identified in anterior gastric wall where there had been signs of vascular stress. The lesion was sutured after revival of its borders, and the patient had good evolution. Prompt diagnosis and immediate treatment of this unusual complication are needed to reduce its high mortality rate. |
| first_indexed | 2024-04-11T16:53:30Z |
| format | Article |
| id | doaj.art-ad855f57c03a4061a22abfceb88c19b4 |
| institution | Directory Open Access Journal |
| issn | 1678-4219 |
| language | English |
| last_indexed | 2024-04-11T16:53:30Z |
| publishDate | 2000-10-01 |
| publisher | Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia (IBEPEGE) |
| record_format | Article |
| series | Arquivos de Gastroenterologia |
| spelling | doaj.art-ad855f57c03a4061a22abfceb88c19b42022-12-22T04:13:20ZengInstituto Brasileiro de Estudos e Pesquisas de Gastroenterologia (IBEPEGE)Arquivos de Gastroenterologia1678-42192000-10-01374227230Gastric necrosis and perforation as a complication of splenectomy. Case report and related referencesCarlos Augusto Real MARTINEZ0Jaques WAISBERG1Rogério Tadeu PALMA2Sansom Henrique BROMBERG3Mário Augusto Padula CASTRO4Paulo Amaral dos SANTOS5Instituto de Assistência Médica ao Servidor Público Estadual de São PauloInstituto de Assistência Médica ao Servidor Público Estadual de São PauloInstituto de Assistência Médica ao Servidor Público Estadual de São PauloInstituto de Assistência Médica ao Servidor Público Estadual de São PauloInstituto de Assistência Médica ao Servidor Público Estadual de São PauloInstituto de Assistência Médica ao Servidor Público Estadual de São PauloNecrosis of the stomach after isolated splenectomy with the formation of gastrocutaneous fistula is a rare event that occurs in less than 1% of splenectomies. It is more frequent when the removal of the spleen is done because of hematological diseases. Its mortality index can reach 60% and its pathogenesis is controversial, as it may be attributed both to direct trauma of the gastric wall and to ischemic phenomena. Although the stomach may exhibit exuberant arterial blood irrigation, anatomical variations can cause a predisposition towards the appearance of potentially ischemic areas, especially after ligation of the short gastric vessels around the major curvature of the stomach. Once this is diagnosed in the immediate postoperative period, it becomes imperative to reoperate. The surgical procedure will depend on the conditions of the peritoneal cavity and patient's clinic status. The objective of this study was to report on the case of a patient submitted to splenectomy because of closed abdominal traumatism, who then presented peritonitis and percutaneous gastric fistula in the post-operative period. During the second operation, perforations were identified in anterior gastric wall where there had been signs of vascular stress. The lesion was sutured after revival of its borders, and the patient had good evolution. Prompt diagnosis and immediate treatment of this unusual complication are needed to reduce its high mortality rate.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-28032000000400008&tlng=enStomach ruptureSplenectomyNecrosisAbdominal injuries |
| spellingShingle | Carlos Augusto Real MARTINEZ Jaques WAISBERG Rogério Tadeu PALMA Sansom Henrique BROMBERG Mário Augusto Padula CASTRO Paulo Amaral dos SANTOS Gastric necrosis and perforation as a complication of splenectomy. Case report and related references Arquivos de Gastroenterologia Stomach rupture Splenectomy Necrosis Abdominal injuries |
| title | Gastric necrosis and perforation as a complication of splenectomy. Case report and related references |
| title_full | Gastric necrosis and perforation as a complication of splenectomy. Case report and related references |
| title_fullStr | Gastric necrosis and perforation as a complication of splenectomy. Case report and related references |
| title_full_unstemmed | Gastric necrosis and perforation as a complication of splenectomy. Case report and related references |
| title_short | Gastric necrosis and perforation as a complication of splenectomy. Case report and related references |
| title_sort | gastric necrosis and perforation as a complication of splenectomy case report and related references |
| topic | Stomach rupture Splenectomy Necrosis Abdominal injuries |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-28032000000400008&tlng=en |
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