Gastric necrosis and perforation as a complication of splenectomy. Case report and related references

Necrosis of the stomach after isolated splenectomy with the formation of gastrocutaneous fistula is a rare event that occurs in less than 1 porcentage of splenectomies. It is more frequent when the removal of the spleen is done because of hematological disease. Its mortality index can reach 60 porcentage and its pathogenisis 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 variantions can cause a predisposition towards the appearance of potentially ischemic areas, especially afterligation of the short gastric vessels around the major curvature of the stomach. Once this is diagnose in the immediate postoperative period, it becomes imperative to reoperate. The surgical procedure will depend on the conditions of the peritoneal cavity and patien's clinic status. The objective of this study was to report on the case of a patient submitte 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 complication are needed to reduce its mortality rate.

Stomach jolt--a possible mechanism for gastrosplenic injury in blunt abdominal trauma.

We report a 30-year-old man was involved in a road accident and had a gastric lesser curve tear and multiple splenic tears near the short gastric vessels. We believe that these resulted from sudden deceleration of a full stomach with sudden rise in intragastric pressure.

Ruptura gástrica espontánea / Spontaneous gastric rupture

Se presenta un caso de ruptura gástrica espontánea intervenido con éxito y sin complicaciones. Se analiza el cuadro clínico y se revisa la literatura. La causa más frecuente es la dilatación gástrica producida por ingestión de alimentos asociados a bicarbonato. Se hace incapié en el tratamiento quirúrgico precoz y el aseo exhaustivo de la cavidad peritoneal como condiciones necesarias para tener buen éxito en la reparación de la lesión

Perforación gástrica en el período neonatal / Gastric perforacion in the newborn

La etiología de la perforación gástrica espontánea en el recién nacido no ha sido bien establecida, siendo ésta poco frecuente en el periodo neonatal y suele ser hallazgo de autopsia. Sin embargo, se han diagnosticado en vida perforaciones gástricas en el recién nacido lográndose mediante adecuada intervención quirúrgica la curación de estos pacientes. Diversas etiologías se han sañalado para explicar dicha patología, tales como la acidez gástrica elevada en el recién nacido asociado a la lesión vascular primaria o a la posibilidad de hipoxia neonatal y choque como causa de la misma. También se mencionan defectos de la musculatura de la pared gástrica o sobredistensión del estómago durante la técnica de reanimación. Dada la poca frecuencia de esta patología en el periodo neonatal nos permitimos reportarlo

Carcinomas gástricos com Hemorragia ou perfuraçäo: uma retrospecçäo com 44 casos / Gastric carcinomas with Haemorrhage or perforation: retrospective study with 44 cases

Da análise retrospectiva de 44 doentes com carcinoma gástrico complicado com hemorragia e/ou perfuraçäo, resultou a mortalidade global de 25,0% (11/44). Em sangramentos, a mortalidade em cirurgias realizads em caráter de urgência foi de 27,3% e, em perfuraçöes, de 44,4%. O índice de ressecabilidade foi de 68,3% (gastrectomia total - sete doentes; gastrectomia subtotal - 21 doentes). A sobrevida, mesmo em doentes ressecados, tem-se mostrado semelhante à observada entre aqueles operados sem estas complicaçöes

Gastric rupture from blunt chest trauma

Gastric rupture due to blunt trauma is a rare condition. In this case, the first to be 'reported from Iraq, chest trauma led to ruptured stomach with minimal abdominal clinical signs