2019 Volume 55 Issue 6 Pages 1076-1080
A 13-year-old girl was treated for congenital heart disease and polysplenia. Bloody vomiting occurred during hospitalization for a cardiac catheter test at the age of 12 years. She was brought to our department, and she was diagnosed as having gastric volvulus complicated by wandering spleen on the basis of abdominal CT findings. She was treated conservatively by depressurization using a nasogastric tube and closely followed-up. However, gastric volvulus recurred multiple times over a short period; therefore, laparoscopic gastropexy and splenectomy were performed. An inversed stomach and spleens of various sizes were observed intraoperatively. Some of the spleens that were fixed to the retroperitoneum were preserved, and the other wandering spleens were excised. Gastropexy was carried out with three points of gastric fixation to the abdominal wall. A nonrotation-type intestinal malrotation was recognized, and prophylactic appendectomy was performed. The postoperative course was excellent, and three years have passed without recurrence. Polysplenia often complicates various cardiovascular and intraabdominal organ malformations such as biliary atresia or intestinal malrotation, but gastric volvulus is very rare. Since radiological images vary among individual cases, careful consideration of imaging results is needed for choosing the appropriate treatment strategy.
