Gastric volvulus in three children with asplenic syndrome

Gastric volvulus was surgically corrected in three patients with asplenic syndrome associated with severe cardiac anomalies. One patient, whose stomach was necrotic, died postoperatively with an intra-abdominal abscess. The other two patients have remained well. Four intra-abdominal abnormalities were found in the three asplenic patients: (1) absent gastrophrenic ligaments; (2) absent gastrosplenic ligaments; (3) deficient fixation of the pylorus, and (4) proximity of the pylorus to the cardia. Cardiac surgeons and pediatricians who treat the asplenic syndrome should be aware of extracardiac anomalies, especially malfixation of the stomach, which can lead to acute gastric volvulus.