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      Wandering Spleen and Organoaxial Gastric Volvulus after Morgagni Hernia Repair: A Case Report and Review of the Literature

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          Abstract

          Wandering spleen and gastric volvulus are two rare entities that have been described in association with congenital diaphragmatic hernia. The diagnosis is difficult and any delay can result in ischemia and necrosis of both organs. We present a case of a 13-year-old girl, previously operated on for anterior diaphragmatic hernia and intrathoracic gastric volvulus, that presented to our service for a subdiaphragmatic gastric volvulus recurrence associated with a wandering spleen. In this report we reviewed the literature, analyzing the clinical presentation, diagnostic assessment, and treatment options of both conditions, in particular in the case associated with diaphragmatic hernia.

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          Most cited references87

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          Surgical treatment of patients with wandering spleen: report of six cases with a review of the literature.

          Wandering spleen, which is defined as a spleen without peritoneal attachments, is a rare disease and a delay in the clinical and/or radiological diagnosis may lead to splenic torsion, infarction, and necrosis. Owing to the physiologic importance of the spleen, especially in children, and the risk of postsplenectomy sepsis, early diagnosis and splenopexy are recommended. In the present article, we describe the results of our management of this rare problem on six patients, and we review all available literature from 1895 to 2005. Briefly, our technique includes flap creation from parietal peritoneum and settlement of spleen in the fossa splenica. Free edges of this flap are stitched to the stomach and the left end of transverse colon and the beginning of the descending colon. The body of the stomach was stitched to the abdominal wall to prevent gastric volvulus, while the fundus region was fixed to the diaphragm to support the spleen. Finally, an omental patch was stitched to the intact abdominal wall above the flap. In conclusion, the procedure of splenopexy without using mesh is considered to be a safe and curative modality for wandering spleen without imposing any undue risk of infection or foreign material reaction.
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            The threatened stomach: management of the acute gastric volvulus.

            Acute presentation of gastric volvulus is a rare condition with a high mortality for acute ischaemia. This study was undertaken to investigate the acute management, diagnosis, and long-term outcomes of patients presenting with acute gastric volvulus.
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              Wandering spleen: an unusual association with gastric volvulus.

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                Author and article information

                Journal
                Case Rep Surg
                Case Rep Surg
                CRIS
                Case Reports in Surgery
                Hindawi Publishing Corporation
                2090-6900
                2090-6919
                2016
                14 September 2016
                : 2016
                : 6450765
                Affiliations
                1Department of Paediatric Surgery, Spedali Civili Children's Hospital, Brescia, Italy
                2Department of Urology, Policlinico Umberto I, Sapienza University, Rome, Italy
                3Department of Emergency Radiology, S. Camillo-Forlanini Hospital, Rome, Italy
                4Department of Paediatric Surgery, S. Camillo-Forlanini Hospital, Rome, Italy
                Author notes

                Academic Editor: Robert Stein

                Author information
                http://orcid.org/0000-0002-6186-8984
                Article
                10.1155/2016/6450765
                5039297
                27703832
                5f7e828f-c2f5-449b-b248-aba736d488a7
                Copyright © 2016 Noemi Cantone et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 12 July 2016
                : 18 August 2016
                Categories
                Case Report

                Surgery
                Surgery

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