Gastric volvulus (GV) is an uncommon pathology, with 10-20% of cases occurring in children, typically before one year of age. It often occurs in people with congenital diaphragmatic hernias, intestinal malrotation, eventration of the diaphragm, paraesophageal hernias, wandering spleens, asplenism, or intra-abdominal adhesions. We report a rare case of chronic GV after left hemihepatectomy for hepatoblastoma in a child. The patient was a 9-year-old boy who complained of upper abdominal pain and postprandial upper abdominal distension for one year. At the age of 4 months, he was diagnosed with hepatoblastoma and had undergone left hemihepatectomy. The upper gastrointestinal contrast study revealed chronic organoaxial gastric volvulus. After a surgical procedure involving adhesiolysis and an anterior wall gastropexy, the patient improved and the symptoms resolved. Although GV is a rare disease, it should be suspected in a patient with a previous abdominal surgical history who is complaining of abdominal distension and pain.
Abdominal Pain ; Child ; Diaphragm ; Gastropexy ; Hepatectomy ; Hepatoblastoma ; Hernia, Hiatal ; Hernias, Diaphragmatic, Congenital ; Humans ; Male ; Pathology ; Rare Diseases ; Stomach Volvulus ; Wandering Spleen

No abstract available.
Adolescent* ; Humans ; Wandering Spleen*

Wandering spleen is a rare clinical condition caused by lax splenic suspensory ligaments. The laxity of ligaments causes torsion of splenic vascular pedicle. CT scan of a 7-year-old girl with abdominal pain showed a non-enhancing lobular mass in lower abdomen. Small bowel loops were located at the right-sided abdomen and colonic loops at the left-sided abdomen. MRI scan showed non-enhancing heterogeneous mass with twisted vascular pedicle. To our knowledge, only a few cases have been reported about wandering spleen diagnosed on MRI.
Abdomen ; Abdominal Pain ; Child ; Colon ; Female ; Humans ; Infarction* ; Ligaments ; Magnetic Resonance Imaging ; Tomography, X-Ray Computed ; Wandering Spleen*

Wandering spleen or splenoptosis is an uncommon entity and often an asymptomatic finding of acute abdomen in the emergency department. A high index of suspicion for splenic torsion is required, particularly in patients with known splenomegaly, as this condition could potentially lead to splenic infarction. Recognition of this condition can help avoid potential confusion with acute abdomen of other aetiologies. Herein, we present a unique case of wandering spleen with chronic torsion, which, to the best of our knowledge, has never been described in an elderly patient with haemoglobin H thalassaemia. We also review the literature for the aetiology and pathogenesis of wandering spleen, and discuss the relevant diagnostic modalities and treatment options.
Abdominal Pain ; Aged ; China ; ethnology ; Female ; Hospitals ; Humans ; Singapore ; Thalassemia ; Tomography, X-Ray Computed ; Torsion Abnormality ; complications ; diagnosis ; surgery ; Wandering Spleen ; complications ; diagnosis ; surgery

Gastric volvulus is a rare disease; only 700 cases have been reported since Berti first described autopsy findings of a patient in 1866. Its symptoms are non-specific and therefore it is difficult to diagnose it early. Acute gastric volvulus has a poor prognosis because it may cause shock and strangulation. Perforation or gastric hemorrhage can also result from ischemia when diagnosis is delayed. Therefore, it requires rapid diagnosis and an emergency operation. Wandering spleen is a rare condition characterized by the absence or underdevelopment of one or all of the ligaments that hold the spleen in its normal position in the abdomen. Wandering spleen and gastric volvulus have a common cause lack of intraperitoneal visceral ligaments. The authors now report a case of wandering spleen accompanying gastric voluvulus, which resulted in wandering spleen and perforation.
Abdomen ; Autopsy ; Emergencies ; Hemorrhage ; Humans ; Ischemia ; Ligaments ; Prognosis ; Shock ; Spleen ; Stomach Volvulus ; Wandering Spleen

Wandering spleen is very rare condition in children characterized by migration of the spleen from its normal position due to laxity or absence of the supporting splenic ligaments. We experienced a case of splenic infarction due to torsion of a wandering spleen in a 6-year-old boy who presented with fever, vomiting, and abdominal pain of 2 day's duration. On physical examination, there was severe tenderness in the left upper quadrant of the abdomen. The plain abdominal radiograph showed marked colonic gaseous distension. Contrast-enhanced abdominal computed tomography scan showed decreased density of spleen in the normal position, consistent with infarction. At emergency laparotomy, a wandering spleen twisted 360degrees on its pedicle was found. Despite splenic detorsion, blood flow could not be restored. Splenectomy was therefore performed. The child was discharged 7 days after surgery without any complications.
Abdomen ; Abdominal Pain ; Child ; Colon ; Emergencies ; Fever ; Humans ; Infarction ; Laparotomy ; Ligaments ; Physical Examination ; Spleen ; Splenectomy ; Splenic Infarction ; Vomiting ; Wandering Spleen

A wandering spleen is a rare entity characterized by incomplete fixation of the spleen by lienorenal and gastrosplenic ligaments. The spleen can migrate to the lower abdomen or pelvis and the condition can be congenital or acquired. We report a case of torsion of a wandering spleen in a patient presenting with progressing mild left upper quadrant pain.
Abdomen ; Abdominal Pain* ; Humans ; Ligaments ; Pelvis ; Spleen ; Wandering Spleen*

Torsion of the spleen is a rare cause of abdominal pain in children and it may occur in conjunction with wandering spleen. Wandering spleen is the presence of the spleen in a location other than the left upper quadrant, and it is secondary to the congenital or functional absence of splenic ligaments. The occurrence of wandering spleen is rare in adults and it's even less common in children. The most common presentation is acute abdominal pain, although the signs and symptoms vary widely. Due to the risk of splenic infarction, making a rapid and accurate diagnosis is essential. When a wandering spleen is diagnosed, the treatment of choice is splenopexy, even if the patient is asymptomatic. If splenic necrosis is present, then splenectomy is usually required. We describe here a 4-year-old girl with torsion of a wandering spleen that was managed by splenopexy.
Abdominal Pain ; Adult ; Child ; Child, Preschool ; Diagnosis ; Female ; Humans ; Ligaments ; Necrosis ; Spleen ; Splenectomy ; Splenic Infarction ; Wandering Spleen*

Wandering spleen is a rare condition characterized by migration of the spleen from its normal position due to laxity or absence of the supporting splenic ligaments. Ultrasonography shows the absence of the spleen in left upper quadrant (LUQ) and the presentation in the lower abdomen of a homognous mass whose sonographic appearance is consistent with that of a spleen. Contrast-enhanced CT reveals the absence of the spleen in LUQ, a soft tissue mass resembling spleen in the lower abdomen, and the splenic pedicle of whirled appearance. We present a case of wandering spleen, which could be diagnosed with US and CT by the ectopic location of spleen and the whirling pattern of splenic pedicle.
Abdomen ; Ligaments ; Spleen ; Tomography, X-Ray Computed ; Ultrasonography ; Wandering Spleen*

Torsion of a wandering spleen is an unusual cause of an acute abdomen and is rarely diagnosed preoperatively. A splenectomy is the treatment of choice in cases of splenic torsion and infarction, while in patients with chronic symptoms, splenopexy may be attempted. I report a case with acute splenic infarction in a young male and review the clinical presentation, etiology, diagnostic procedures and treatment modalities in a wandering spleen.
Abdomen, Acute ; Humans ; Infarction* ; Male ; Splenectomy ; Splenic Infarction ; Wandering Spleen*