期刊论文详细信息
Arquivos de Gastroenterologia
Gastric necrosis and perforation as a complication of splenectomy. Case report and related references
Carlos Augusto Real Martinez1  Jaques Waisberg1  Rogério Tadeu Palma1  Sansom Henrique Bromberg1  Mário Augusto Padula Castro1  Paulo Amaral Dos Santos1 
[1] ,Instituto de Assistência Médica ao Servidor Público Estadual de São PauloSão Paulo SP ,Brazil
关键词: Stomach rupture;    Splenectomy;    Necrosis;    Abdominal injuries;    Ruptura gástrica;    Esplenectomia;    Necrose;    Traumatismos abdominais;   
DOI  :  10.1590/S0004-28032000000400008
来源: SciELO
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【 摘 要 】

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.

【 授权许可】

CC BY-NC   
 All the contents of this journal, except where otherwise noted, is licensed under a Creative Commons Attribution License

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