|
1
|
Kozman M, Ali F, Keller B, Hershey D. Hematemesis From Varices in a 14-year-old Without Hepatobiliary Disease: A "Wandering" Diagnosis. Pediatrics 2022; 149:186867. [PMID: 35485171 DOI: 10.1542/peds.2020-016469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/23/2022] [Indexed: 11/24/2022] Open
Affiliation(s)
- Maggie Kozman
- Departments of Internal Medicine.,Pediatrics.,Division of Pediatrics Hospital Medicine, Rady Children's Hospital San Diego, Department of Pediatric Hospital Medicine, San Diego, California.,Departments of Internal Medicine and Pediatrics, Harbor UCLA Medical Center Internal Medicine and Pediatrics, Los Angeles, California
| | | | - Benjamin Keller
- Pediatric Surgery, University of California San Diego, San Diego, California
| | | |
Collapse
|
|
2
|
Sun C, Li SL. Successful treatment of floating splenic volvulus: Two case reports and a literature review. World J Clin Cases 2021; 9:8812-8819. [PMID: 34734060 PMCID: PMC8546827 DOI: 10.12998/wjcc.v9.i29.8812] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 05/24/2021] [Accepted: 08/23/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The floating spleen refers to the spleen moving away from the normal anatomical position to other parts of the abdominal cavity.
CASE SUMMARY In this report, we describe two cases of torsion of floating spleen, which were successfully treated by laparoscopic partial splenectomy and retroperitoneal fixation of the residual spleen. The clinical characteristics of previously reported cases are also discussed.
CONCLUSION In conclusion, laparoscopic partial resection of splenic volvulus infarction and extraperitoneal fixation of residual spleen are safe and reliable.
Collapse
Affiliation(s)
- Chi Sun
- Department of Pediatric Surgery, The Second Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei Province, China
| | - Suo-Lin Li
- Department of Pediatric Surgery, The Second Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei Province, China
| |
Collapse
|
|
3
|
Jha AK, Bhagwat S, Dayal VM, Suchismita A. Torsion of spleen and portal hypertension: Pathophysiology and clinical implications. World J Hepatol 2021; 13:774-780. [PMID: 34367498 PMCID: PMC8326160 DOI: 10.4254/wjh.v13.i7.774] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 05/28/2021] [Accepted: 07/02/2021] [Indexed: 02/06/2023] Open
Abstract
The displacement of spleen from its normal location to other places is known as wandering spleen (WS) and is a rare disease. The repeated torsion of WS is due to the presence of long pedicle and absence/laxity of anchoring ligaments. A WS is an extremely rare cause of left-sided portal hypertension (PHT) and severe gastric variceal bleeding. Left-sided PHT usually occurs as a result of splenic vein occlusion caused by splenic torsion, extrinsic compression of the splenic pedicle by enlarged spleen, and splenic vein thrombosis. There is a paucity of data on WS-related PHT, and these data are mostly in the form of case reports. In this review, we have analyzed the data of 20 reported cases of WS-related PHT. The mechanisms of pathogenesis, clinico-demographic profile, and clinical implications are described in this article. The majority of patients were diagnosed in the second to third decade of life (mean age: 26 years), with a strong female preponderance (M:F = 1:9). Eleven of the 20 WS patients with left-sided PHT presented with abdominal pain and mass. In 6 of the 11 patients, varices were detected incidentally on preoperative imaging studies or discovered intraoperatively. Therefore, pre-operative search for varices is required in patients with splenic torsion.
Collapse
Affiliation(s)
- Ashish Kumar Jha
- Department of Gastroenterology, Indira Gandhi Institute of Medical Sciences, Patna 800014, India.
| | - Sameer Bhagwat
- Department of Gastroenterology, Indira Gandhi Institute of Medical Sciences, Patna 800014, India
| | - Vishwa Mohan Dayal
- Department of Gastroenterology, Indira Gandhi Institute of Medical Sciences, Patna 800014, India
| | - Arya Suchismita
- Department of Paediatric Hepatology, Institute of Liver and Biliary Sciences, Delhi 110070, India
| |
Collapse
|
|
4
|
Chue KM, Tan JKH, Pang NQ, Kow AWC. Laparoscopic splenectomy for a wandering spleen with resultant splenomegaly and gastric varices. ANZ J Surg 2020; 90:2124-2125. [PMID: 32017329 DOI: 10.1111/ans.15737] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2019] [Revised: 01/16/2020] [Accepted: 01/17/2020] [Indexed: 12/18/2022]
Affiliation(s)
- Koy Min Chue
- Department of General Surgery, University Surgical Cluster, National University Health System, Singapore
| | - Jarrod Kah Hwee Tan
- Department of General Surgery, University Surgical Cluster, National University Health System, Singapore
| | - Ning Qi Pang
- Division of Hepatobiliary and Pancreatic Surgery, University Surgical Cluster, National University Health System, Singapore
| | - Alfred Wei Chieh Kow
- Division of Hepatobiliary and Pancreatic Surgery, University Surgical Cluster, National University Health System, Singapore
| |
Collapse
|
|
5
|
Sato M, Miyaki Y, Tochikubo J, Onoda T, Shiiya N, Wada H. Laparoscopic splenectomy for a wandering spleen complicating gastric varices: report of a case. Surg Case Rep 2015; 1:3. [PMID: 26943371 PMCID: PMC4747945 DOI: 10.1186/s40792-014-0003-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Accepted: 11/14/2014] [Indexed: 12/18/2022] Open
Abstract
Wandering spleen is a rare clinical entity, and its chronic torsion of the vascular pedicle result in splenic vein occlusion leading to gastric varices. Here, we present a case of wandering spleen complicating gastric varices in a 40-year-old female. Three-dimensional CT (3D-CT) clearly showed the disruption of the splenic vein at the origin of the vascular pedicle and collateral development of the gastric varices. The patient was electively treated with laparoscopic splenectomy. Difficulty of prediction of the splenic vein recanalization to improve the varices was the reason for the use of splenectomy versus splenopexy. The varices were successfully diminished 3 months after the surgery. After review of cases of complicating gastric varices in the literatures, splenectomy is still a secure way to treat an adult patient with wandering spleen with complicating gastric varices.
Collapse
Affiliation(s)
- Masanori Sato
- First Department of Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama Higashiku, Hamamatsu, Shizuoka, 431-3192, Japan.
| | - Yuichiro Miyaki
- First Department of Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama Higashiku, Hamamatsu, Shizuoka, 431-3192, Japan.
| | - Junpei Tochikubo
- First Department of Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama Higashiku, Hamamatsu, Shizuoka, 431-3192, Japan.
| | - Takanobu Onoda
- First Department of Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama Higashiku, Hamamatsu, Shizuoka, 431-3192, Japan.
| | - Norihiko Shiiya
- First Department of Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama Higashiku, Hamamatsu, Shizuoka, 431-3192, Japan.
| | - Hidetoshi Wada
- First Department of Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama Higashiku, Hamamatsu, Shizuoka, 431-3192, Japan.
| |
Collapse
|
|
6
|
Köseoğlu H, Atalay R, Büyükaşık NŞ, Canyiğit M, Özer M, Solakoğlu T, Akın FE, Bolat AD, Yürekli ÖT, Ersoy O. An Unusual Reason for Gastric Variceal Hemorrhage: Wandering Spleen. Indian J Surg 2013; 77:750-1. [PMID: 26730110 DOI: 10.1007/s12262-013-0993-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2013] [Accepted: 10/07/2013] [Indexed: 12/20/2022] Open
Abstract
Wandering spleen is the displacement of the spleen due to the loss or weakening of the ligaments of the spleen and is seen very rarely with an incidence of less than 0.5 %. It can cause portal hypertension, but gastric variceal hemorrhage is a quite rare condition within the spectrum of this uncommon disease. We report a 22-year-old woman with wandering spleen presenting with life-threatening gastric variceal hemorrhage. Her diagnosis was made by computerized tomography. Endoscopic therapy was not adequate to stop the bleeding, and urgent splenectomy was performed. After surgery she has been well with no symptoms until now.
Collapse
Affiliation(s)
- Hüseyin Köseoğlu
- Department of Gastroenterology, Faculty of Medicine, Yildirim Beyazit University, Ankara, Turkey
| | - Roni Atalay
- Department of Gastroenterology, Ankara Ataturk Research and Education Hospital, Ankara, Turkey
| | - Naciye Şemnur Büyükaşık
- Department of Gastroenterology, Ankara Ataturk Research and Education Hospital, Ankara, Turkey
| | - Murat Canyiğit
- Department of Radiology, Ankara Ataturk Research and Education Hospital, Ankara, Turkey
| | - Mehmet Özer
- Department of General Surgery, Ankara Ataturk Research and Education Hospital, Ankara, Turkey
| | - Tevfik Solakoğlu
- Department of Gastroenterology, Ankara Ataturk Research and Education Hospital, Ankara, Turkey
| | - Fatma Ebru Akın
- Department of Gastroenterology, Ankara Ataturk Research and Education Hospital, Ankara, Turkey
| | - Aylin Demirezer Bolat
- Department of Gastroenterology, Ankara Ataturk Research and Education Hospital, Ankara, Turkey
| | - Öykü Tayfur Yürekli
- Department of Gastroenterology, Ankara Ataturk Research and Education Hospital, Ankara, Turkey
| | - Osman Ersoy
- Department of Gastroenterology, Faculty of Medicine, Yildirim Beyazit University, Ankara, Turkey
| |
Collapse
|