CASE REPORT article
Front. Oncol.
Sec. Cancer Imaging and Image-directed Interventions
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1638866
Case Report: Ultrasound-guided interventional diagnosis and treatment of gastrosplenic fistula caused by lymphoma
Provisionally accepted
- The Second Hospital of Dalian Medical University, Dalian, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Gastrosplenic fistula is a rare complication, most often secondary to gastric or splenic lymphoma.Severe gastrosplenic fistula can cause life-threatening upper gastrointestinal bleeding, making early diagnosis and intervention critical for a favorable prognosis. Currently, surgical intervention remains the primary treatment; however, outcomes are often suboptimal. In this paper, we present a case involving ultrasound-guided interventional diagnosis and treatment of gastrosplenic fistula caused by diffuse large B-cell lymphoma. An 18-year-old male initially presented with gastric distension and epigastric pain and was diagnosed with gastric non-Hodgkin lymphoma (diffuse large B-cell lymphoma) at an outside hospital before being referred to our institution for further management.Contrast-enhanced CT revealed an abnormal density lesion between the gastric fundus and spleen, suggestive of gastric perforation accompanied by adjacent exudation and localized abscess formation.A multidisciplinary team evaluation identified markedly elevated inflammatory markers and poor overall condition, rendering the patient unsuitable for immediate surgery. Subsequent B-mode ultrasound and contrast-enhanced ultrasound (CEUS) precisely delineated the fistula location and extent of the abscess, enabling determination of a safe puncture path. Ultrasound-guided percutaneous catheter drainage of the gastrosplenic fistula was then successfully performed. Postprocedural intracavitary contrast injection confirmed correct catheter tip placement distal to the fistula. Follow-up CT imaging 20 days after drainage showed a significant reduction in the encapsulated fluid and gas collection at the fistula site. After one month of clinical improvement, the patient underwent total gastrectomy with resection of the pancreatic body-tail and spleen. He was subsequently discharged and continued maintenance chemotherapy for non-Hodgkin lymphoma. At 13 months postoperatively, the patient remains clinically stable with normal vital signs.
Keywords: lymphoma1, gastrosplenic fistula2, Ultrasound3, interventional4, contrast-enhanced ultrasound5
Received: 31 May 2025; Accepted: 05 Aug 2025.
Copyright: © 2025 Zhang, Li, Li and Song. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Manxi Li, The Second Hospital of Dalian Medical University, Dalian, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.