Gastric Variceal Hemorrhage Secondary to Torsion of Wandering Spleen

Laparoscopic splenectomy for a wandering spleen complicating gastric varices: report of a case

“…Wandering spleen is a rare clinical entity, and its complication with gastric varices is even rarer [ 1 , 4 ]. The gastric varices most likely arose from splenic vein occlusion secondary to chronic torsion of the vascular pedicle, leading to retrograde congestion of the short gastric and left gastroepiploic veins.…”

“…Splenectomy was selected for two young patients complicating with not only gastric but also portal and mesenteric varices [ 6 ]. However, only a single case reported by Wani S et al underwent detorsion and splenopexy in which elimination of the gastric varices was confirmed with the follow-up endoscopy [ 4 ]. Thus, splenectomy was employed in almost all cases.…”

Laparoscopic splenectomy for a wandering spleen with resultant splenomegaly and gastric varices

“…4 To date, there were a total of 16 cases of wandering spleens reported in literature. 4,8 All patients except one 9 had undergone a splenectomy with outstanding results. 4,8 A splenectomy remains the definitive standard of care for a wandering spleen should there be evidence of splenic infarction or splenic vessel thrombosis.…”

An Unusual Reason for Gastric Variceal Hemorrhage: Wandering Spleen

“…The patients may present with nausea, vomiting, or cramp-like pain [1,3]. Acute abdomen, splenic infarction, splenic abscess, hypersplenism, pancreatitis, pancreas necrosis, gastric volvulus, and gastric outlet obstruction are rare complications [1,2,4].…”

“…Decompression of splenic venous outflow occurs through the short gastric veins to the coronary vein, producing variceal channels in the gastric cardia and fundus and, consequently, gastric variceal hemorrhage [5,6]. Gastric variceal hemorrhage occurs rarely in wandering spleen [4,5].…”