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

作者：E Moore, JW O’Brien, Nabeel Merali, N Farkas, A Madhavan, Nima Abbassi‐Ghadi, Shaun R. Preston, Pritam Singh · 发表于：Annals of The Royal College of Surgeons of England · 年份：2023 · DOI：10.1308/rcsann.2022.0149 · 被引用次数：7 · 研究领域：Abdominal Trauma and Injuries、Foreign Body Medical Cases、Congenital Anomalies and Fetal Surgery

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: 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 ...