Abstract
A 69-year-old man was referred to our department with an exorbitant foetor ex ore, dysphagia and dyspepsia. Upper endoscopy had been performed prior by an outpatient gastroenterologist and the patient had received an eradication therapy for a Helicobacter pylori-induced gastritis. At admission upper endoscopy showed a gastric ulcer which drained a stinking fluid. Endosonography, computed tomography and an upper gastrointestinal series with water soluble media revealed a gastrocolic fistula. Multiple biopsies showed a low-grade gastric MALT lymphoma. Therefore, a surgical reconstruction with Roux-en-Y esophagojejunostomy and transverso-descendostomy was performed. The histology of the completely removed stomach revealed a high-grade Non Hodgkin Lymphoma (NHL) with parts of a low-grade NHL. 3 weeks after surgery chemotherapy was started with the CHOP-regime which was well-tolerated by the patient.
MeSH terms
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Aged
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Colonic Diseases / diagnosis*
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Colonic Diseases / pathology
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Colonic Diseases / surgery
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Gastrectomy
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Gastric Fistula / diagnosis*
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Gastric Fistula / pathology
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Gastric Fistula / surgery
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Gastric Mucosa / pathology
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Gastroscopy
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Helicobacter Infections / diagnosis*
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Helicobacter Infections / pathology
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Helicobacter Infections / surgery
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Helicobacter pylori*
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Humans
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Intestinal Fistula / diagnosis*
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Intestinal Fistula / pathology
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Intestinal Fistula / surgery
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Lymphoma, B-Cell, Marginal Zone / diagnosis*
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Lymphoma, B-Cell, Marginal Zone / pathology
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Lymphoma, B-Cell, Marginal Zone / surgery
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Lymphoma, Non-Hodgkin / diagnosis
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Lymphoma, Non-Hodgkin / pathology
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Lymphoma, Non-Hodgkin / surgery
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Male
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Peptic Ulcer Perforation / diagnosis*
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Peptic Ulcer Perforation / pathology
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Peptic Ulcer Perforation / surgery
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Stomach Neoplasms / diagnosis*
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Stomach Neoplasms / pathology
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Stomach Neoplasms / surgery
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Stomach Ulcer / diagnosis*
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Stomach Ulcer / pathology
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Stomach Ulcer / surgery
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Tomography, X-Ray Computed