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

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.

Wandering spleen in a geriatric patient – a rare presentation of gastric volvulus

“…Approximately 22 million Americans have limited English proficiency. Despite the use of trained interpreters or ‘language lines’, 2 mistrust and difficulties in direct communications still exist. Communication and cultural barriers potentially played a role in the informed consent of this patient.…”

“…The presentation ranges from an incidental finding during abdominal imaging to volvulus of an associated intra-abdominal organ, typically the stomach, followed by sudden onset of abdominal pain. 2 A gastric volvulus secondary to a wandering spleen is considered a surgical emergency due to compromised blood flow. We herein report an atypical presentation of gastric outlet obstruction in a geriatric patient caused by acute mesenteroaxial gastric volvulus precipitated by a wandering spleen.…”

Hypermobile spleen in congenital diaphragmatic hernia. Prevention and correction of complications

“…У недавніх публікаціях описано окремі випадки блукаючої селезінки, що спричинила такі ускладнення, як обструкція шлунка, дванадцятипалої та тонкої кишок, а також заворот шлунка [2,4,11,12]. У досліджених нами пацієнтів виявлено мобільну селезінку, що призвела до обструкції зовнішніх жовчовивідних шляхів з імітацією кісти холедоха, а також до деформації шлунка з провокацією ШСР.…”

Contrast-Enhanced Computed Tomography Findings of the Torsioned Wandering Spleen: A Case Report

“…A complete or in-complete embryologic developmental anomaly of these ligaments may give rise to a wandering spleen. Among the other etiological factors are ligamentous laxity and the congenital or acquired defects of the diaphragm (3). The most important ones of the acquired factors are the advanced laxity and abdominal wall fatigue which arise due to the hormonal irregularities caused by multipari-ty (4).…”

“…Among the other etiological factors are ligamentous laxity and the congenital or acquired defects of the diaphragm. [ 3 ] The most important ones of the acquired factors are the advanced laxity and abdominal wall fatigue that arise due to the hormonal irregularities caused by multiparity. [ 4 ] A substantially increased splenic mobility is an important cause of a torsioned wandering spleen.…”