IntroductionÂ
Gastrosplenic fistula (GSF) is a rare entity characterized by an
abnormal communication between the gastric cavity and the spleen.
Reported etiologies of GSF are splenic or gastric malignancies, splenic
abscess, crohn’s disease, peptic ulcers disease, sickle cell disease,
sleeve gastrectomy and abdominal trauma1,2. Diffuse
large B cell lymphoma (DLBCL) is the most common malignancy resulting in
GSF1,2. Predominant symptoms at clinical presentation
are abdominal pain, hematemesis, melena, and constitutional symptoms
such as generalized weakness, fever and weight loss. Imaging findings of
air bubbles and leakage of oral contrast from gastric cavity into the
spleen is diagnostic of GSF3. Prognosis and short-term
survival in patients with GSF are good (up to 82%) in patients
presented without gastrointestinal bleeding (GIB)4. A
small proportion of patients with GSF may present with life-threatening
GIB. We present a case of GSF secondary to type V gastric ulcer
associated with upper GIB.