Colosplenic fistula as a complication of splenic abscess

Hashemzadeh, Shahryar; Pouryousef, Kamrooz; Oliaei-Motlagh, Mohammad; Jalilzadeh-Binazar, Mehran; Teimouri-Dereshki, Amir

doi:10.1111/ans.13482

Cited by 5 publications

(5 citation statements)

References 3 publications

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“…Pathological examination of the colon and the spleen in this case revealed acute inflammatory changes and perforation adjacent to the splenic lesion, without evidence of malignancy or inflammatory bowel disease. This finding is consistent with the literature, which reports various causes for colosplenic fistulae, including inflammatory diseases, trauma, and complications from previous medical interventions [12][13][14][15][16][17][18][19]. In a recent case series and literature review, the predominant etiologies were colonic lymphoma (30%) and colorectal carcinoma (17%) [19].…”

Section: Discussionsupporting

confidence: 90%

Colosplenic Fistula Following Splenic Embolization in a Sickle Cell Disease Patient

Al Jabri,

Al Masrouri,

Al Adawi

et al. 2024

Cureus

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This case report details a rare instance of a colosplenic fistula following splenic embolization in a patient with sickle cell disease. The patient, a 29-year-old female, presented with symptoms of left hypochondrial pain and fever. Imaging revealed a splenic abscess characterized by an air-fluid level. Intraoperative observations disclosed that the spleen was entirely replaced by an abscess cavity, with the presence of colosplenic fistulae. A splenectomy and colonic resection were performed. This report highlights a rare complication that occurred a long time after splenic embolization, underscoring the need for a high level of suspicion to prevent serious complications.

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Section: Discussionsupporting

confidence: 90%

Colosplenic Fistula Following Splenic Embolization in a Sickle Cell Disease Patient

Al Jabri,

Al Masrouri,

Al Adawi

et al. 2024

Cureus

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“…In rare cases, embolization may result in ischemic or necrotic tissue changes within the spleen, potentially leading to infection or abscess formation [8][9][10]. If an embolized spleen becomes infected and subsequently forms a splenic abscess, it is possible for the abscess to erode into adjacent structures, most common being the stomach forming a gastro-splenic fistula [13]. Fistulization may however occur to the colon, forming a SCF, which can manifest as rectal bleeding as in our patient.…”

Section: Discussionmentioning

confidence: 68%

A Rare Case of Splenocolonic Fistula Presenting as Rectal Bleeding after Non-Operative Management of Blunt Splenic Trauma and Review of the Literature

2023

J Surg

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Background: Non-Operative Management of Splenic Injuries (NOMSI) is the standard approach to blunt splenic trauma in the stable patient. Complications of NOMSI are well documented, however splenocolonic fistulas (SCFs) are rare and usually due to chronic inflammatory or neoplastic events. After NOMSI, SCFs are extremely rare and knowledge around incidence and presenting complaints entirely unknown.Objective: To present a rare case of SCF after non-operative management of blunt splenic trauma in a patient who presented without abdominal pain, but rectal bleeding.

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“…The search strategy retrieved 141 references, of which 26 studies were included 1 – 3 , 5 – 26 (Fig. 1 ).…”

Section: Resultsmentioning

confidence: 99%

“…Other presenting symptoms included nausea/vomiting (23%), anemia (20%), and hemodynamic instability (13%). The most common causes of CsF were colon lymphoma (30%), colorectal adenocarcinoma (17%) 2 , 3 , 5 – 10 , 14 , 23 – 25 , Crohn’s disease 1 , 6 – 8 (13%), and infection (10%). The most common diagnostic modalities used to assess CsF was a computed tomography (CT) scan (90%), in which enteral contrast could be seen entering the spleen in seven cases.…”

Section: Resultsmentioning

confidence: 99%

Colosplenic fistula diagnosis and management: a case series and review of literature

Hernandez Dominguez,

Lincango,

Spivak

et al. 2024

International Journal of Surgery

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Background: A colosplenic fistula (CsF) is an extremely rare complication. Its diagnosis and management remain poorly understood, owing to its infrequent incidence. Our objective was to systematically review the etiology, clinical features, diagnosis, management, and prognosis to help clinicians gain a better understanding of this unusual complication and provide aid if it is to be encountered. Methods: A systematic review of studies reporting CsF diagnosis in Ovid MEDLINE, Ovid EMBASE, Scopus, Web of Science, and Wiley Cochrane Library from 1946 to June 2022. Additionally, a retrospective review of four cases at our institution were included. Cases were evaluated for patient characteristics (age, sex, and comorbidities), CsF characteristics including causes, symptoms at presentation, diagnosis approach, management approach, pathology findings, intraoperative complications, postoperative complications, 30-day mortality, and prognosis were collected. Results: Thirty patients with CsFs were analyzed, including four cases at our institution and 26 single-case reports. Most of the patients were male (70%), with a median age of 56 years. The most common etiologies were colonic lymphoma (30%) and colorectal carcinoma (17%). Computed tomography (CT) was commonly used for diagnosis (90%). Approximately 87% of patients underwent a surgical intervention, most commonly segmental resection (81%) of the affected colon and splenectomy (77%). Nineteen patients were initially managed surgically, and 12 patients were initially managed nonoperatively. However, 11 of the nonoperative patients ultimately required surgery due to unresolved symptoms. The rate of postoperative complications was (17%). Symptoms resolved with surgical intervention in 25 (83%) patients. Only one patient (3%) had had postoperative mortality. Conclusions: Our review of 30 cases worldwide is the largest in literature. CsFs are predominantly complications of neoplastic processes. CsF may be successfully and safely treated with splenectomy and resection of the affected colon, with a low rate of postoperative complications.

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Colosplenic fistula as a complication of splenic abscess

Cited by 5 publications

References 3 publications

Colosplenic Fistula Following Splenic Embolization in a Sickle Cell Disease Patient

Colosplenic Fistula Following Splenic Embolization in a Sickle Cell Disease Patient

A Rare Case of Splenocolonic Fistula Presenting as Rectal Bleeding after Non-Operative Management of Blunt Splenic Trauma and Review of the Literature

Colosplenic fistula diagnosis and management: a case series and review of literature

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