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Gastrosplenic Fistula: a Systematic Review
Saurabh Borgharia1, Preeti Juneja1, Priya Hazrah1
1Department of General Surgery, Lady Hardinge Medical College, New Delhi, India.
Indian Journal of Surgical Oncology
|October 3, 2022
Summary
Gastrosplenic fistula, a rare complication of gastric and splenic issues, often leads to severe bleeding. This review analyzes its causes, diagnosis, and management based on existing literature.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Radiology
Background:
- Gastrosplenic fistula (GSF) is an uncommon complication of gastric and splenic diseases.
- It poses significant clinical importance due to its association with life-threatening upper gastrointestinal hemorrhage.
- Malignant pathologies are more frequently implicated than benign conditions.
Purpose of the Study:
- To review the English-language literature on gastrosplenic fistula.
- To enhance understanding of etiological factors, diagnostic approaches, and management strategies.
- To consolidate findings from case reports, series, and reviews.
Main Methods:
- Systematic literature search on PubMed and MEDLINE (January 1950 - September 2020).
- Adherence to Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines.
- Inclusion of 44 relevant articles: 3 case series, 37 case reports, 4 literature reviews.
Main Results:
- Identified 36 malignant and 10 benign cases of gastrosplenic fistula.
- Lymphomas, particularly splenic lymphomas, are the most common cause of malignant GSF.
- Gastric adenocarcinoma is a rare cause; GSF can occur spontaneously or secondary to chemotherapy-induced tumor necrosis.
Conclusions:
- Gastrosplenic fistula is an exceptional complication, predominantly linked to gastrointestinal malignancies.
- Splenic lymphomas represent the most frequent etiology.
- Further research may elucidate optimal diagnostic and therapeutic pathways for this rare condition.
