Staged Surgical Management of a Colosplenic Fistula Caused by Locally Advanced Splenic-Flexure Adenocarcinoma

Colosplenic fistula is a rare complication most commonly associated with colonic lymphoma, adenocarcinoma, and Crohn's disease. In unstable and septic patients, a staged strategy consisting of initial laparoscopic source control and diversion followed by definitive multivisceral resection can balance urgent management of sepsis with adherence to oncological therapy.