RESUMO
Malignant neoplasms of the spleen rare. We report a case of primary lymphoma of the spleen associated with gastro-splenic fistulae. The gastric wall wasn't infiltrated by the neoplasm; a communication between the spleen and the stomach was found.
Assuntos
Fístula/etiologia , Fístula Gástrica/etiologia , Linfoma/complicações , Esplenopatias/etiologia , Neoplasias Esplênicas/complicações , Adulto , Humanos , MasculinoRESUMO
Thirty-two cases are presented of carcinoma of the gastric stump after surgery for gastroduodenal ulcer disease, duodenal in 19 patients (59.38%) and gastric in 13 (40.65%). All underwent gastric resection, with Billroth I type reconstruction in 5 cases (15.62%) and Billroth II in 27 (84.36%). The patients generally had very advanced carcinoma at the time of diagnosis and the studies made, barium contrast and endoscopy, were always positive. The operability rate was 84.26% and the rate of curative resectability was 28.12%, this group of patients attaining the longest survival. An evaluation was made of the possible mechanisms implicated in the pathogenesis of this type of carcinoma, type of operation performed, location of the peptic lesion, type of reconstruction, etc. A follow-up protocol was established for the patients who underwent resection, the degree of risk being evaluated in relation to the postoperative period. Finally, to prevent the potentially neoplastic stage of the gastric stump, we present surgical procedures for the treatment of the ulcerative disease which have not been demonstrated to increase the long-term risk of gastric carcinoma.
