{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,28]],"date-time":"2026-06-28T04:07:30Z","timestamp":1782619650336,"version":"3.54.5"},"reference-count":11,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","license":[{"start":{"date-parts":[[2012,1,1]],"date-time":"2012-01-01T00:00:00Z","timestamp":1325376000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2013,7,16]],"date-time":"2013-07-16T00:00:00Z","timestamp":1373932800000},"content-version":"vor","delay-in-days":562,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/3.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2012,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>INTRODUCTION:<\/jats:title>\n                    <jats:p>Primary colonic lymphoma is rare. It comprises less than 1% of large bowel malignancies. Affected patients often present with non-specific vague symptoms with subsequent delays in diagnosis and management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PRESENTATION OF CASE:<\/jats:title>\n                    <jats:p>An immuno-competent 35-year-old male presented with left iliac fossa pain, fever and constipation. Clinical examination revealed left-sided abdominal peritonism. After the initial radiological and endoscopic investigations, a provisional diagnosis of a localized perforation of a splenic flexure diverticulum was made and ultrasound-guided percutaneous drainage of the abscess was performed. The patient failed to settle on conservative treatment and therefore exploratory laparotomy was carried out. An inflammatory phlegmon consisting of a left paracolic gutter abscess, the spleen and the splenic flexure of the colon was resected en-bloc and a primary colo-colic anastomosis was performed. His operative recovery was complicated by wound infection which was treated conservatively. The histopathology revealed colo-splenic fistula secondary to a perforated colonic non-Hodgkin's lymphoma. The spleen contained multiple metastatic lymphomatous deposits. He was started on chemotherapy and remained well at 5-year follow up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DISCUSSION:<\/jats:title>\n                    <jats:p>Colon non-Hodgkin's lymphoma may present initially with an acute abdomen due to perforation. It mimics any acute surgical condition. Perforation and fistulaization into the spleen is very rare.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION:<\/jats:title>\n                    <jats:p>This case highlights the delay and difficulty in diagnosing primary colonic lymphoma without resorting to surgical resection.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.ijscr.2012.04.013","type":"journal-article","created":{"date-parts":[[2012,4,28]],"date-time":"2012-04-28T15:49:11Z","timestamp":1335628151000},"page":"368-371","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":9,"title":["Colonic lymphoma presenting acutely with perforated colo-splenic fistula"],"prefix":"10.1097","volume":"3","author":[{"given":"Ali Ahmed","family":"Al-Zahir","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdul-Wahed 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