An infarcted wandering spleen leading to a sigmoid volvulus presenting with acute large bowel obstruction: a case report

• Published in: Annals of the Royal College of Surgeons of England Vol. 103; no. 4; pp. e127 - e130
• Main Authors: Hamdy, O, Yousry, M, Saleh, G A
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 01.04.2021; Royal College of Surgeons
• Subjects: Abdomen; Acute Disease; Antigens; Blood; Coffee; Colon; Endoscopy; Female; Humans; Intestinal obstruction; Intestinal Obstruction - diagnosis; Intestinal Obstruction - etiology; Intestinal Obstruction - surgery; Intestinal Volvulus - diagnosis; Intestinal Volvulus - etiology; Intestinal Volvulus - surgery; Ischemia; Magnetic resonance imaging; Middle Aged; Online Case Report; Pelvis; Sigmoid Diseases - diagnosis; Sigmoid Diseases - etiology; Sigmoid Diseases - surgery; Signs; Spleen; Splenectomy; Splenic Infarction - complications; Splenic Infarction - diagnosis; Splenic Infarction - surgery; Wandering Spleen - complications; Wandering Spleen - diagnosis; Wandering Spleen - surgery; X-rays; Intestinal obstruction; Infarction; Sigmoid volvulus; Wandering spleen
• ISSN: 0035-8843; 1478-7083
• DOI: 10.1308/rcsann.2020.7144

A wandering spleen is a very rare event characterised by the absence of the spleen in its anatomical position due to the hyperlaxity of its ligaments. We present a case of wandering spleen complicated by splenic vascular pedicle torsion, thrombosis and subsequent splenic infarction. Compression of the infarcted spleen on the rectosigmoid junction led to the development of a sigmoid volvulus, which presented as an acute large bowel obstruction. The patient underwent emergency laparotomy, splenectomy, sigmoid decompression and sigmoidopexy. After a follow-up period of two years, the volvulus had not recurred.