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Gastric volvulus and wandering spleen
1Department of Pediatrics, University of Iowa College of Medicine, Iowa City, USA.
The American Journal of Gastroenterology
|July 22, 1998
Summary
Gastric volvulus and wandering spleen, rare in children, share a congenital cause. This case highlights diagnostic challenges, with imaging confirming both conditions only on the third presentation.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Developmental Biology
Background:
- Gastric volvulus and wandering spleen are rare pediatric conditions.
- Both conditions share a common etiology: congenital absence of intraperitoneal visceral attachments.
- Abnormalities in visceral fixation can lead to these rare presentations.
Observation:
- A patient presented with recurrent intractable vomiting and an abdominal mass, but no abdominal pain.
- Initial episodes of gastric volvulus resolved spontaneously with nasogastric tube placement, delaying diagnosis.
- Diagnosis was challenging as intermittent resolution prevented timely investigation.
Findings:
- Mesenteroaxial gastric volvulus and wandering spleen were diagnosed during the third episode.
- Diagnostic imaging, performed before nasogastric tube insertion, was crucial for diagnosis.
- This case represents a rare association between gastric volvulus and wandering spleen.
Implications:
- Highlights the importance of considering rare congenital anomalies in pediatric patients with recurrent vomiting.
- Emphasizes the diagnostic utility of imaging before intervention in suspected cases.
- Suggests that congenital fixation abnormalities can manifest in complex and rare combinations.