Gastric outlet obstruction secondary to a wandering spleen: systematic review and surgical management of a case

Autor: E Moore, JW O’Brien, N Merali, N Farkas, A Madhavan, N Abbassi-Ghadi, S Preston, P Singh
Rok vydání: 2023
Předmět:
Zdroj: The Annals of The Royal College of Surgeons of England.
ISSN: 1478-7083
0035-8843
DOI: 10.1308/rcsann.2022.0149
Popis: 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: OpenAIRE
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