Acute gastric hemorrhage secondary to wandering spleen

Angerås, Ulf; Almskog, B; Lukes, P.; Lundstam, Sven; Weiss, Lilian

doi:10.1007/bf01317093

Cited by 35 publications

(12 citation statements)

References 10 publications

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“…79 A delayed diagnosis or treatment may cause torsion of the vascular pedicle leading to life-threatening complications such as gangrene of the spleen, hypersplenism, severe bleeding from esophageal varices, intestinal obstruction, gastric or intestinal gangrene, and acute pancreatitis. 52,[118][119][120] Because of the absolute need for surgery in patients with WS, several innovative surgical procedures have been developed. Until recently, a splenectomy by open laparotomy was the standard treatment for this condition.…”

Section: Discussionmentioning

confidence: 99%

Surgical Treatment of Patients with Wandering Spleen: Report of Six Cases with a review of the literature

et al. 2007

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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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Section: Discussionmentioning

confidence: 99%

Surgical Treatment of Patients with Wandering Spleen: Report of Six Cases with a review of the literature

et al. 2007

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“…A unique presentation of acute gastric hemorrhage secondary to wandering spleen has also been reported by Angeras et al[8]. In that case, a pedicular tortion resulted in impaired blood return via the splenic vein.…”

Section: Discussionmentioning

confidence: 53%

Spontaneous massive hemoperitoneum: A potentially life threatening presentation of the wandering spleen

2011

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Context:Wandering spleen is an unusual condition characterized by the absence or maldevelopment of one or all of the ligaments securing the spleen in its normal position in the left upper abdomen. Pedicular tortion with a complete vascular disruption is a rare but known potential complication of this mostly congenital disorder. Spontaneous hemoperitoneum with acute abdomen however, is a life threatening situation that has not been adequately reported in the adult literature.Case Report:A forty four year old man presented to the emergency department with an acutely distended and rigid abdomen. His past medical history was only significant for mild mental retardation. The patient denies prior abdominal operation or recent trauma. On initial examination, he appeared to be anxious, pale, and tachycardic. Fullness in the midpelvic region was easily appreciated on palpation. An enlarged pelvic spleen and free intraperitoneal fluid consistent with blood were seen on a CT scan. The patient was promptly taken for an exploratory laparotomy where a large rush of blood was encountered upon entering the abdomen. A volvulus of the splenic pedicle with an infarcted spleen was found mandating a splenectomy.Conclusions:Abnormally located spleen, splenomegaly, and finding of hemoperitoneum are highly suggestive of wandering spleen with tortioned pedicle. Despite its life threatening presentation, immediate laparotomy and splenectomy invariably result in good outcome.

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“…Isolated splenic vein thrombosis with left sided portal hypertension is a rare cause of upper gastrointestinal bleed [1]. Diseases of the pancreas have been identified as the most common cause of isolated splenic vein thrombosis [2].…”

Section: Introductionmentioning

confidence: 99%

Post traumatic intra thoracic spleen presenting with upper GI bleed! – a case report

et al. 2006

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Acute gastric hemorrhage secondary to wandering spleen

Cited by 35 publications

References 10 publications

Surgical Treatment of Patients with Wandering Spleen: Report of Six Cases with a review of the literature

Surgical Treatment of Patients with Wandering Spleen: Report of Six Cases with a review of the literature

Spontaneous massive hemoperitoneum: A potentially life threatening presentation of the wandering spleen

Post traumatic intra thoracic spleen presenting with upper GI bleed! – a case report

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