A distinctive case of gastrosplenic fistula: comprehending melioidosis

Authors

  • Clement Prakash T. J. Department of Surgery, St. Johns National Academy of Health Sciences, Bangalore, Karnataka,
  • John Abraham Department of Family Medicine, St. Johns National Academy of Health Sciences, Bangalore, Karnataka, India
  • Ambikha Akhoury Atal Bihari Vajpayee Medical College and Research Institute, Bangalore, Karnataka, India
  • S. Sophia Department of Surgery, St. Johns National Academy of Health Sciences, Bangalore, Karnataka, India
  • Anieta Merin Jacob Department of Oral Medicine and Radiology, Shri Venkateswara Dental College and Hospital, Bangalore, Karnataka, India

DOI:

https://doi.org/10.18203/2349-2902.isj20241751

Keywords:

Burkholderia pseudomallei, Gastro splenic fistula, Contrast enhanced computer tomography, Oesophago gastro duodenoscopy

Abstract

This case report delves into an exceedingly rare case of gastrosplenic fistula and concurrent upper GI bleeding in the setting of melioidosis. Although upper GI bleeding is often encountered in the clinical setting, the co-existence of a gastrosplenic fistula adds an unprecedented amount of complexity. Melioidosis is an infectious disease endemic to certain geographic regions of the world, namely that of Southeast Asia and Northern Australia. Burkholderia pseudomallei, the culprit organism, is associated with bioterrorism on account of which it has gained notoriety in recent years. This case underscores the array of diagnostic challenges that were combated and the prompt surgical intervention in the form of a splenectomy and partial gastrectomy that culminated in a favorable outcome. Coordination in a temporal fashion and multidisciplinary collaboration between surgeons and physicians was imperative to success. This report emphasizes the significance of recognizing and addressing the atypical manifestations of the disease as it challenges the conventional understanding of melioidosis and offers significant insights into the realm of infectious disease, at large.

References

Wiersinga WJ, Virk HS, Torres AG, Currie BJ, Peacock SJ, Dance DAB, et al. Melioidosis. Nat Rev Dis Primers. 2018;4:17107.

Saravu K, Mukhopadhyay C, Vishwanath S, Valsalan R, Docherla M, Vandana KE, et al. Melioidosis in southern India: epidemiological and clinical profile. Southeast Asian J Trop Med Public Health. 2010;41(2):401-9.

Chinnakkulam Kandhasamy S, Elamurugan TP, Naik D, Rohith G, Nelamangala Ramakrishnaiah VP. Systemic Melioidosis With Ruptured Splenic Abscess. Cureus. 2020;12(5):e7956.

Chen H, Hu ZQ, Fang Y, et al. A case report: Splenic abscess caused by Burkholderia pseudomallei. Medicine (Baltimore). 2018;97(26):e11208.

Kingsley PV, Arunkumar G, Tipre M, Leader M, Sathiakumar N. Pitfalls and optimal approaches to diagnose melioidosis. Asian Pac J Trop Med. 2016;9(6):515-24.

Gupta AP, Halder R, Chakraborty M, Chakraborty PP. Isolated splenic abscess due to melioidosis in type 1 diabetes mellitus: laboratory diagnosis of Burkholderia pseudomallei in resource-restricted setting. BMJ Case Rep. 2021;14(2):e238985.

Lee WS, Choi ST, Kim KK. Splenic abscess: a single institution study and review of the literature. Yonsei Med J. 2011;52(2):288-92.

Borgharia S, Juneja P, Hazrah P, Lal R, Kapur N, Chaudhary P. Gastrosplenic Fistula: a Systematic Review. Indian J Surg Oncol. 2022;13(3):652-60.

Alsinan A, Alelq M, Alsugair F, Hassan A, Waheed A, Alshomimi S. Gastro-splenic fistula, a rare presentation of sickle cell disease patient with splenic abscess: Case report and literature review. Int J Surg Case Rep. 2019;57:22-4.

Campisi A, Rocca L, Altieri G, Fico V, Pepe G, Lodoli C. Splenic abscess with spontaneous gastrosplenic fistula: case report and review of the literature. J Surg Case Rep. 2023;2023(12):rjad647.

Maytapa J, Thanapirom K, Kullavanijaya P, Komolmit P. Gastrointestinal: Splenic abscesses-related gastrosplenic fistula: Unusual complication of melioidosis. J Gastroenterol Hepatol. 2018;33(6):1163.

Ding YL, Wang SY. Gastrosplenic fistula due to splenic large B-cell lymphoma. J Res Med Sci. 2012;17(8):805-7.

Downloads

Published

2024-06-27

Issue

Section

Case Reports