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‘Wandering spleen with acute torsion’ : a rare indication for splenectomy in an adult, complicated by postoperative splanchnic venous thrombosis and intestinal gangrene
  1. Geet Midha1,
  2. Suraj Surendran2,
  3. Myla Yacob2 and
  4. Inian Samarasam2
  1. 1General Surgery, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
  2. 2General and Upper Gastrointestinal Surgery, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
  1. Correspondence to Dr Suraj Surendran; suraj.cmc{at}cmcvellore.ac.in

Abstract

Wandering spleen (WS) is a hypermobile spleen that, due to the laxity of its ligaments, is prone to torsion. We report a case of a 45-year-old multiparous woman who presented with acute abdominal pain and a tender palpable mass. A contrast-enhanced computed tomography scan of the abdomen showed a WS with torsion. She underwent an emergency splenectomy and was discharged after an uneventful recovery. She was readmitted with splanchnic venous thrombosis and was managed with therapeutic low-molecular-weight heparin (LMWH) and discharged. Twenty days later, she presented with new-onset abdominal pain. She had not complied with LMWH as advised. The thrombosis had progressed, leading to small bowel gangrene, requiring resection and a stoma. Due to frequent metabolic disturbances, an early reversal of stoma was performed. She was lost to follow-up thereafter. This case highlights a rare indication for emergency splenectomy and one of its major postoperative complications.

  • gastrointestinal surgery
  • general surgery
  • emergency medicine
  • radiology
  • portal vein

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Footnotes

  • Contributors GM helped with the concept, design, data collection, literature search, manuscript preparation and editing. SS helped with the concept, design, data collection, literature search, manuscript preparation, editing and review. MY helped with the concept, literature search, manuscript preparation, editing and review. IS helped with the concept, literature search, manuscript preparation editing and review and is the guarantor.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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