Wandering spleen with pancreatic volvulus and colonic obstruction in an elderly patient

Wandering spleen is a rare clinical condition which occurs due to laxity or absence of the normal intraperitoneal ligaments that hold the spleen in place. Gastric volvulus and wandering spleen share a common etiology of absence or laxity of intraperitoneal ligaments. The occurrence of simultaneous pancreatic volvulus has never been described before in adolescence. Herein, we report a case having wandering spleen with torsion, and gastric and distal pancreatic volvulus, an unusual triad in acute abdomen in an emergency setting, which has never been described before to the best of our knowledge.

show abstract

“…[789] It occurs because of entrapment of the tail in the twisted splenorenal ligament during torsion of spleen.…”

Section: Discussionmentioning

confidence: 99%

“…Pancreatic volvulus is a rare entity, with only a few isolated cases described in conjunction with wandering spleen. [ 7 8 9 ] It occurs because of entrapment of the tail in the twisted splenorenal ligament during torsion of spleen.…”

Section: Discussionmentioning

confidence: 99%

Pancreatic volvulus with wandering spleen and gastric volvulus: An unusual triad for acute abdomen in a surgical emergency

Gorsi

Bhatia

Gupta

et al. 2014

Saudi J Gastroenterol

View full text Add to dashboard Cite

show abstract

“…The clinical presentation of wandering spleen is variable, however, patients normally present with acute abdominal pain due to acute torsion of the splenic pedicle with splenic infarction or ischemia. It may also be diagnosed incidentally on a routine abdominal screening [8], [11], [12], [13]. The patient in our case report presented with acute abdominal pain, nausea, vomiting, and fever.…”

Section: Discussionmentioning

confidence: 99%

Concurrent occurrence of a wandering spleen, organoaxial gastric volvulus, pancreatic volvulus, and cholestasis – A rare cause of an acute abdomen

Frimpong

Aboagye²,

Ayisi-Boateng

et al. 2019

Radiology Case Reports

View full text Add to dashboard Cite

The concurrence of wandering spleen, organoaxial gastric volvulus, and pancreatic volvulus is very rare. They have been associated with symptoms such as severe abdominal pain, abdominal distention, and vomiting. However, the diagnosis remains complicated and any delay can result in ischemia and necrosis of the organs involved. In this case presentation, we present a unique case involving a 14-year-old girl who presented initially with acute abdominal pain. Assessment with enhanced computed tomography scan led to the diagnosis of wandering spleen, organoaxial gastric volvulus, and pancreatic volvulus, in addition to cholestasis, making it the first study to report on the simultaneous occurrence of this triad and cholestasis.

show abstract

“…Fewer than 500 cases have been reported in the literature, although the actual incidence is probably unknown because of several asymptomatic unrecognized cases . Associated torsion of the distal pancreas is even rarer, with only four cases having been previously reported (Table ).…”

Section: Discussionmentioning

confidence: 99%

“…When the embryonic posterior mesogastrium incompletely fuses, the lienorenal ligament fails to develop and the pancreas is not completely retroperitoneal. In this condition, the distal portion of the pancreatic body and the tail are included in the intraperitoneal splenic hilum, and they could be trapped in the twisted splenorenal ligament during torsion of spleen . Patients may present with occasional nausea and chronic or intermittent mild cramps, making the disease unrecognizable for a long time ;; although in a review of WS from 2002 to 2012, 64% of children with WS had splenic torsion as a main complication .…”

Section: Discussionmentioning

confidence: 99%

Urgent laparoscopic mesh splenopexy for torsion of wandering spleen and distal pancreas: A case report

Torri

Parolini

Vanzetti

et al. 2015

Asian J Endoscop Surgery

View full text Add to dashboard Cite

Wandering spleen is a condition in which an incomplete fusion of the splenic ligaments allows the spleen to move within the abdomen, predisposing it to splenic torsion along its vascular pedicle. Torsion of a wandering spleen is an uncommon occurrence, especially in children, and associated torsion of the distal pancreas is even more unusual, with only four cases having been reported in adults. Non-specific clinical presentation makes radiologic evaluation essential in order to obtain a diagnosis and to send the patient for early surgery before life-threatening complications arise. Here we present a rare case of torsion of wandering spleen together with volvulus of the distal pancreas in a 13-year-old girl. In this case, prompt radiological assessment allowed for an early diagnosis, and the patient was successfully treated with urgent laparoscopic derotation of both the spleen and the distal pancreas as well as mesh splenopexy. To the best of our knowledge, this procedure has never been described in a pediatric setting.

show abstract

Wandering spleen with pancreatic volvulus and colonic obstruction in an elderly patient

Cited by 6 publications

References 6 publications

Pancreatic volvulus with wandering spleen and gastric volvulus: An unusual triad for acute abdomen in a surgical emergency

Pancreatic volvulus with wandering spleen and gastric volvulus: An unusual triad for acute abdomen in a surgical emergency

Concurrent occurrence of a wandering spleen, organoaxial gastric volvulus, pancreatic volvulus, and cholestasis – A rare cause of an acute abdomen

Urgent laparoscopic mesh splenopexy for torsion of wandering spleen and distal pancreas: A case report

Contact Info

Product

Resources

About