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Challenge of diagnosing splenic torsion in a paediatric patient with gastroschisis
  1. Elliott S Gordon1,2,
  2. Lauren A Wagner1,2 and
  3. Joanne M Kennedy1,2
  1. 1Department of Pediatrics, Mercer University School of Medicine, Macon, Georgia, USA
  2. 2Department of Pediatrics, Atrium Health Navicent Beverly Knight Olson Children's Hospital, Macon, Georgia, USA
  1. Correspondence to Dr Elliott S Gordon; elliottsgordon{at}gmail.com

Abstract

Gastroschisis is an uncommon congenital defect of the abdominal wall resulting in intestinal prolapse, most commonly associated with short gut syndrome or bowel obstruction. Wandering spleen, movement of the spleen due to the underdevelopment of splenic ligaments, has a prevalence of 0.25% and is asymptomatic in 15% of paediatric cases. An 11-year-old patient, admitted with a history of gastroschisis repaired at birth, presents with 18 months of intermittent, worsening abdominal pain. Imaging demonstrated splenomegaly and tortuosity of the splenic vein with abnormal positioning of the superior mesenteric artery and vein. The patient was found to have a wandering spleen with subacute splenic infarct secondary to splenic torsion, necessitating emergent surgical intervention. This patient experienced an extremely rare complication of gastroschisis that has not previously been reported. This complication is caused by a lack of appropriate abdominal fixation points for the spleen.

  • gastroenterology
  • paediatric surgery
  • stomach wall
  • congenital disorders

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Footnotes

  • Contributors ESG completed the initial drafts. All authors conceptualised the report and were equally involved in the editing and editorialising process.

  • 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.

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

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