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Laparoscopic gastropexy for the treatment of gastric volvulus associated with wandering spleen.
J Laparoendosc Adv Surg Tech A. 2009 Apr; 19 Suppl 1:S137-9.JL

Abstract

A 2.5-year-old boy was referred to the emergency room for a sudden onset of diffuse and increasing abdominal pain with lethargy, abdominal distension, and vomiting, all in the past 24 hours. A plain abdominal X-ray showed gastric distension. Two liters of gastric contents were evacuated by suction. The abdominal sonogram showed an unusual position of the spleen in the left-lower quadrant, with no splenic ischemia. The diagnosis of gastric volvulus associated with a wandering spleen was then evoked. Laparoscopic exploration revealed a nonischemic spleen, absence of normal supporting ligaments for the spleen, and gastric distension with flaccid gastric walls. The spleen was then easily moved in the left-under quadrant. A parietal peritoneal posterolateral incision was made, opposite the large gastric curve, up to the diaphragm (7 cm). This delimitated a sharp demarcation zone between the two edges of the incised peritoneum. The stomach was fixed to the peritoneal incision, covering and anchoring the spleen in a good position. Recovery was uneventful, and an abdominal sonogram performed 4 years after the surgery shows a viable spleen in its correct location. The rarity of gastric volvulus associated with a wandering spleen and its fast clinical improvement with medical treatment often delays the diagnosis and the surgical treatment. Laparoscopy in this case has a dual relevance: diagnosis and therapeutic management (splenectomy or gastropexy). Laparoscopic gastropexy for the treatment of gastric volvulus associated with a wandering spleen is an easy procedure and combines the advantages of all the surgical techniques previously described.

Authors+Show Affiliations

Department of Pediatric Surgery, American Hospital, Reims, France. caro_mtp@hotmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

19281417

Citation

François-Fiquet, Caroline, et al. "Laparoscopic Gastropexy for the Treatment of Gastric Volvulus Associated With Wandering Spleen." Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A, vol. 19 Suppl 1, 2009, pp. S137-9.
François-Fiquet C, Belouadah M, Chauvet P, et al. Laparoscopic gastropexy for the treatment of gastric volvulus associated with wandering spleen. J Laparoendosc Adv Surg Tech A. 2009;19 Suppl 1:S137-9.
François-Fiquet, C., Belouadah, M., Chauvet, P., Lefebvre, F., Lefort, G., & Poli-Merol, M. L. (2009). Laparoscopic gastropexy for the treatment of gastric volvulus associated with wandering spleen. Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A, 19 Suppl 1, S137-9. https://doi.org/10.1089/lap.2008.0091.supp
François-Fiquet C, et al. Laparoscopic Gastropexy for the Treatment of Gastric Volvulus Associated With Wandering Spleen. J Laparoendosc Adv Surg Tech A. 2009;19 Suppl 1:S137-9. PubMed PMID: 19281417.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Laparoscopic gastropexy for the treatment of gastric volvulus associated with wandering spleen. AU - François-Fiquet,Caroline, AU - Belouadah,Mohamed, AU - Chauvet,Philippe, AU - Lefebvre,Francis, AU - Lefort,Gérard, AU - Poli-Merol,Marie Laurence, PY - 2009/3/14/entrez PY - 2009/3/14/pubmed PY - 2009/12/30/medline SP - S137 EP - 9 JF - Journal of laparoendoscopic & advanced surgical techniques. Part A JO - J Laparoendosc Adv Surg Tech A VL - 19 Suppl 1 N2 - A 2.5-year-old boy was referred to the emergency room for a sudden onset of diffuse and increasing abdominal pain with lethargy, abdominal distension, and vomiting, all in the past 24 hours. A plain abdominal X-ray showed gastric distension. Two liters of gastric contents were evacuated by suction. The abdominal sonogram showed an unusual position of the spleen in the left-lower quadrant, with no splenic ischemia. The diagnosis of gastric volvulus associated with a wandering spleen was then evoked. Laparoscopic exploration revealed a nonischemic spleen, absence of normal supporting ligaments for the spleen, and gastric distension with flaccid gastric walls. The spleen was then easily moved in the left-under quadrant. A parietal peritoneal posterolateral incision was made, opposite the large gastric curve, up to the diaphragm (7 cm). This delimitated a sharp demarcation zone between the two edges of the incised peritoneum. The stomach was fixed to the peritoneal incision, covering and anchoring the spleen in a good position. Recovery was uneventful, and an abdominal sonogram performed 4 years after the surgery shows a viable spleen in its correct location. The rarity of gastric volvulus associated with a wandering spleen and its fast clinical improvement with medical treatment often delays the diagnosis and the surgical treatment. Laparoscopy in this case has a dual relevance: diagnosis and therapeutic management (splenectomy or gastropexy). Laparoscopic gastropexy for the treatment of gastric volvulus associated with a wandering spleen is an easy procedure and combines the advantages of all the surgical techniques previously described. SN - 1092-6429 UR - https://www.unboundmedicine.com/medline/citation/19281417/Laparoscopic_gastropexy_for_the_treatment_of_gastric_volvulus_associated_with_wandering_spleen_ L2 - https://www.liebertpub.com/doi/10.1089/lap.2008.0091.supp?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -