Splenic Volvulus Research Articles

Splenetic Torsion on Ectopic Spleen: A Case Report

Splenic volvulus, a rare torsion of the spleen around its vascular axis, can lead to severe tissue necrosis without prompt treatment. Underlying anatomical factors such as elongation of the splenic pedicle and ligament laxity increase the risk of torsion. Diagnosis is often made during emergency surgical intervention due to the rarity of the condition and the lack of specificity of symptoms. A 30-year-old woman presented with acute abdominal symptoms accompanied by fever, leading to emergency laparotomy revealing splenic volvulus. Imaging, particularly computed tomography, plays a crucial role in diagnosis. Treatment typically involves splenectomy in cases of necrosis. Wandering spleen, usually caused by ligament hyperlaxity, is a rare but important entity to recognize, often requiring surgical intervention to prevent serious complications.

Uncommon Cause of Acute Abdomen: Ectopic Pelvic Spleen

The ectopic spleen is rare, characterized by splenic hyper-mobility resulting from laxity or poor development of the splenic suspensory ligaments.this allows to wandering spleen to draw, by the force of gravity, to the lower abdomen attached only to its abnormally elargated vascular pedicule. It is usually detected in the childhood. The clinical presentation is vaious; it may attributed to complications: torsion, rupture, arterial infraction and compresion. Diagnosis in emergency situations can be difficult because splenic volvulus is a rare cause of an acute abdomen. We present and discuss a case of an ectopic spleen in the pelvic position leading to paroxysmal abdominal pain, diagnosed by ultrasound, confirmed by computed tomography and treated by splenectomy.

Volvulus of the stomach and wandering spleen after repair of congenital diaphragmatic hernia: unexpected manifestations in a neonate

BackgroundCongenital diaphragmatic hernia (CDH) is sometimes associated with complications involving herniation of intrathoracic organs, which further increase mortality rate. We encountered a case of postoperative gastric and splenic volvulus shortly after left CDH repair in a female neonate who was treated with gastropexy.Case presentationAt 39 weeks gestation, a female patient with left Bochdalek CDH was delivered (birth weight: 3748 g, Apgar score: 3/4). The patient was provided ventilator support with nitric oxide. After pulmonary hypertension improved, CDH repair was performed via the abdominal approach on day 7. The stomach, small intestine, large intestine, and spleen were herniated through a diaphragmatic defect of 4 × 2 cm. Although the diaphragm was directly closed, it was tight and the reconstructed diaphragm “dome” was shallow, restricting space for the spleen and stomach. Nonetheless, the spleen was positioned in the left upper abdomen and the stomach was positioned medially. The postoperative course was complicated by organo-axial gastric volvulus, and laparotomy was performed on day 14. In addition to the gastric volvulus, we confirmed a wandering splenic volvulus. The spleen was easily detorted and returned to the left upper abdomen. However, the patient experienced relapse of gastric volvulus without splenic volvulus. Gastropexy was performed electively on day 47. Postoperatively, the patient could be fed orally, and the patient’s development was satisfactory 6 years after surgery.ConclusionsThe cause of these rare complications appeared to be tight direct diaphragmatic closure, which reduced space for the spleen and stomach beneath the left diaphragm.

Acute Gastric Volvulus in Eight-Year-Old Male

An 8-year-old child is admitted to a surgical unit for abdominal pain, with clinical diagnosis of acute abdomen. At exploration, organoaxial gastric volvulus and splenic volvulus were found. Necrosis and gangrene of the whole stomach are treated with total gastrectomy. Gastric volvulus is a rare acute surgical condition in children. It requires urgent surgical treatment to avoid irreversible ischemic changes in the stomach and possibly spleen.

Spleen and gastrosplenic ligament preserving distal pancreatectomy under a minimum incision approach assisted by laparoscopy

As a modification of hand-assisted laparoscopic pancreatectomy, we devised a method of spleen and gastrosplenic ligament preserving distal pancreatectomy, in which pancreatic resection is performed under direct vision extracorporeally. The distal pancreas and spleen are pulled out of the peritoneal cavity through the minilaparotomy at the epigastrium following hand-assisted laparoscopic dissection of the distal pancreas. Spleen-preserving pancreatectomy is performed safely under direct vision. The gastrosplenic ligament is also preserved to prevent splenic volvulus after the operation. The transected main pancreatic duct is doubly ligated, and the transected pancreatic stump is sewn manually. The preserved spleen and splenic vessels are placed back in the peritoneal cavity after resection. In the current study (n = 3), overall morbidity rate, including splenic volvulus and pancreatic fistula, was 0%. Preservation of the gastrosplenic ligament and extracorporeal preparation of the transected pancreatic stump under direct vision are useful measures in spleen-preserving distal pancreatectomy under a minimum incision approach assisted by laparoscopy.

Volvulus of the Spleen

Volvulus of the spleen in absence of malarious splenomegaly is rare. Most reported instances occur in young and middle-aged women and are related to a congenital abnormality of the mesogastrium, pregnancy, and multiparity. In this reported case of splenic volvulus in a young, multiparous woman, posterior mesogastrium malformation was the cause. Certain preoperative findings could suggest this infrequent diagnosis in future cases.