Wandering Spleen and Acute Gastric Volvulus in an Elderly Woman with Acute Abdomen: A Case Report

Abstract

Somprakas Basu,1 Arvind Pratap,2 Satyanam Kumar Bhartiya,2 Vijay Kumar Shukla2 1Department of General Surgery, All India Institute of Medical Sciences, Rishikesh, India; 2Department of General Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, IndiaCorrespondence: Somprakas Basu, Department of General Surgery, All India Institute of Medical Sciences, Rishikesh, 249203, India, Email [email protected]: Gastric volvulus is an uncommon clinical condition with the potentially life-threatening complication of acute gastric necrosis. A wandering spleen may also be associated with gastric volvulus and can produce a diagnostic dilemma as the cause of an acute abdomen. We present a case of an elderly woman who presented with acute abdominal symptoms. She did not have the classical Borchardt triad to diagnose gastric volvulus and had a coexisting wandering spleen. Although torsion and ischemia of the wandering spleen were initially thought to be the cause of acute abdomen, a subsequent contrast-enhanced CT (CECT) scan confirmed a coexistent mesenteric-axial gastric volvulus with gangrenous changes. We present this case to highlight a rare combination of pathologies, either of which can confuse the diagnosis or cause a delay in management. Early diagnosis with CECT is emphasized, and segmental resection is feasible when the rest of the viscus can be preserved.Keywords: gastric volvulus, gastric gangrene, wandering spleen, acute abdomen

Keywords

• gastric volvulus
• gastric gangrene
• wandering spleen
• acute abdomen