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      Wandering spleen with gastric volvulus and intestinal non-rotation in an adult male patient

      case-report

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          Abstract

          We report an extremely rare case of wandering spleen (WS) complicated with gastric volvulus and intestinal non-rotation in a male adult. A 22-year-old man who had been previously treated for Wilson disease was admitted with severe abdominal pain. Radiological findings showed WS in the midline of the pelvic area. The stomach was mesenteroaxially twisted and intestinal non-rotation was observed. Radiology results did not show any evidence of splenic or gastrointestinal (GI) infarction. Elective emergency laparoscopy confirmed WS and intestinal non-rotation; however, gastric volvulus was not observed. It was suspected that the stomach had untwisted when gastric and laparoscopic tubes were inserted. Surgery is strongly recommended for WS because of the high risk of serious complications; however, some asymptomatic adult patients are still treated conservatively, such as the patient in this study. The present case is reported with reference to the literature.

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          Review of genetic factors in intestinal malrotation

          Vicki Martin, Charles Shaw-Smith (2010)
          Intestinal malrotation is well covered in the surgical literature from the point of view of operative management, but few reviews to date have attempted to provide a comprehensive examination of the topic from the point of view of aetiology, in particular genetic aetiology. Following a brief overview of molecular embryology of midgut rotation, we present in this article instances of and case reports and case series of intestinal malrotation in which a genetic aetiology is likely. Autosomal dominant, autosomal recessive, X-linked and chromosomal forms of the disorder are represented. Most occur in syndromic form, that is to say, in association with other malformations. In many instances, recognition of a specific syndrome is possible, one of several examples discussed being the recently described association of intestinal malrotation with alveolar capillary dysplasia, due to mutations in the forkhead box transcription factor FOXF1. New advances in sequencing technology mean that the identification of the genes mutated in these disorders is more accessible than ever, and paediatric surgeons are encouraged to refer to their colleagues in clinical genetics where a genetic aetiology seems likely.
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            Surgical treatment of patients with wandering spleen: report of six cases with a review of the literature.

            Arianeb Mehrabi, Markus W. Büchler, Hamidreza Fonouni … (2006)
            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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              Wandering spleen: an unusual association with gastric volvulus.

              Ridge K F Lau, Huai-Tzu Michael Liu (2007)
              Article 0 comments Cited 21 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Acta Radiol Short Rep
                Journal ID (iso-abbrev): Acta Radiol Short Rep
                Journal ID (publisher-id): ARR
                Journal ID (hwp): sparr
                Title: Acta Radiologica Short Reports
                Publisher: SAGE Publications (Sage UK: London, England )
                ISSN (Electronic): 2047-9816
                Publication date (Electronic): 18 November 2013
                Publication date Collection: November 2013
                Volume: 2
                Issue: 7
                Electronic Location Identifier: 2047981613499755
                Affiliations
                [1 ]Department of Radiology, Toho University Ohashi Medical Center, Tokyo, Japan
                [2 ]Department of Surgery, Toho University Ohashi Medical Center, Tokyo, Japan
                [3 ]Department of Pediatrics, Toho University Ohashi Medical Center, Tokyo, Japan
                Author notes
                [*]Minako Ooka, Department of Radiology, Toho University Ohashi Medical Center, Tokyo, Japan. Email: minako@ 123456inahos.jp
                Article
                Publisher ID: 10.1177_2047981613499755
                DOI: 10.1177/2047981613499755
                PMC ID: 3863963
                PubMed ID: 24349711
                SO-VID: a394cf01-96d6-4c4c-aa5e-88cdaf6303df
                Copyright © © The European Society of Cardiology 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav
                History
                Date received : 4 May 2013
                Date accepted : 28 May 2013
                Categories
                Subject: Case Report
                Custom metadata
                edited-state corrected-proof

                Keywords: abdomen/gi,ct,mesentery,adults and pediatrics,congenital,connective tissue disorders
                Data availability:
                Keywords: abdomen/gi, ct, mesentery, adults and pediatrics, congenital, connective tissue disorders

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