Gastric outlet obstruction secondary to a wandering spleen: systematic review and surgical management of a case.
| Autor: | Moore E; Royal Surrey NHS Foundation Trust, UK., O'Brien JW; University of Surrey, UK., Merali N; University of Surrey, UK., Farkas N; University of Surrey, UK., Madhavan A; Royal Surrey NHS Foundation Trust, UK., Abbassi-Ghadi N; Royal Surrey NHS Foundation Trust, UK., Preston S; Royal Surrey NHS Foundation Trust, UK., Singh P; Royal Surrey NHS Foundation Trust, UK. |
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| Jazyk: | angličtina |
| Zdroj: | Annals of the Royal College of Surgeons of England [Ann R Coll Surg Engl] 2023 Jul; Vol. 105 (6), pp. 501-506. Date of Electronic Publication: 2023 Jan 23. |
| DOI: | 10.1308/rcsann.2022.0149 |
| Abstrakt: | Introduction: A wandering spleen occurs when laxity or absence of the suspensory ligaments allows migration throughout the abdomen. Gastric outlet obstruction resulting from this abnormality is rare. We present a systematic literature search and a case that was managed successfully with surgical intervention at our centre. Methods: A systematic search of the PubMed, Embase™, Medline ® and Google Scholar™ databases was carried out employing the combined search terms "gastric outlet obstruction" AND "wandering spleen". Six results were included for final analysis. Results: All six search results described a single case each. Patients underwent surgical management (open or laparoscopic) after initial investigation utilising a range of modalities. There were no mortalities reported at 90 days. The single case we present was complicated by gastric perforation; the patient made a successful recovery following open splenopexy and stapled wedge resection of the stomach. Conclusions: A wandering spleen is a rare diagnosis and there are only six reported cases of gastric outlet obstruction secondary to a wandering spleen in the literature. None report associated gastric perforation. There are a variety of presenting symptoms, intraoperative findings and operative techniques used to address the gastrosplenic abnormality. The case reported by our centre adds to this limited evidence base and demonstrates a successful outcome from definitive surgical management. We highlight the need to seek early gastro-oesophageal expertise if any gastric pathology is found together with anatomical abnormality of the spleen. |
| Databáze: | MEDLINE |
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