J Korean Soc Radiol.  2016 May;74(5):326-330. 10.3348/jksr.2016.74.5.326.

Multidetector Computed Tomography Findings of Mesenteroaxial Gastric Volvulus Combined with Torsion of Wandering Spleen: A Case Report and Literature Review

Affiliations
  • 1Department of Radiology, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Korea. radlsl@catholic.ac.kr

Abstract

Gastric volvulus, defined as an abnormal rotation of stomach, may be idiopathic or secondary to abnormal fixation of intraperitoneal visceral ligaments. Wandering spleen is a movable spleen resulting from absence or underdevelopment of the splenic supporting ligaments that suspend the spleen to its normal position in the left part of the supramesocolic compartment of the abdomen. Wandering spleen increases the risk of splenic torsion. Both gastric volvulus and splenic torsion are potentially life-threatening if not urgently managed with surgery. Prompt and accurate diagnosis based on multidetector computed tomography (MDCT) is crucial to prevent unforeseen complications. Gastric volvulus and coexistent torsion of wandering spleen is a very rare condition. Herein, we described a case of gastric volvulus associated with wandering spleen and intestinal non-rotation in a 15-year-old girl focusing on MDCT findings.


MeSH Terms

Abdomen
Adolescent
Diagnosis
Female
Humans
Intestines
Ligaments
Multidetector Computed Tomography*
Spleen
Stomach
Stomach Volvulus*
Wandering Spleen*

Figure

  • Fig. 1 A 15-year-old girl with acute mesenteroaxial gastric volvulus, torsion of wandering spleen and intestinal non-rotation. B, C. Axial contrast-enhanced CT images reveal rotated spleen in counter clockwise direction resulting in decreased perfusion (black arrows in B and C). The spleen is observed anteriorly to the pancreas. The pancreas is medially displaced with kinking in its tail portion (white arrow in C). D, E. Coronal reformatted CT images show that the splenic artery (arrowheads in D) from celiac trunk is twisted in counter clockwise direction. The hypoattenuated spleen is located in the midline of upper abdomen (black arrows in D and E). The right gastroepiploic artery (arrowheads in E) runs superomedially. The upside-down positional change of the right gastroepiploic artery as a vascular landmark of the gastrocolic ligament is also noted.


Reference

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