Experience in the Treatment of Two Cases of Wandering Spleen That Required Additional Gastropexy After Splenopexy

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  • Kawano Masato
    Department of Pediatric Surgery, Research Field in Medical and Health Sciences, Medical and Dental Area, Research and Education Assembly, Kagoshima University
  • Muto Mitsuru
    Department of Pediatric Surgery, Research Field in Medical and Health Sciences, Medical and Dental Area, Research and Education Assembly, Kagoshima University
  • Nagano Ayaka
    Department of Pediatric Surgery, Research Field in Medical and Health Sciences, Medical and Dental Area, Research and Education Assembly, Kagoshima University
  • Matsui Mayu
    Department of Pediatric Surgery, Research Field in Medical and Health Sciences, Medical and Dental Area, Research and Education Assembly, Kagoshima University
  • Yano Keisuke
    Department of Pediatric Surgery, Research Field in Medical and Health Sciences, Medical and Dental Area, Research and Education Assembly, Kagoshima University
  • Onishi Shun
    Department of Pediatric Surgery, Research Field in Medical and Health Sciences, Medical and Dental Area, Research and Education Assembly, Kagoshima University
  • Yamada Koji
    Department of Pediatric Surgery, Research Field in Medical and Health Sciences, Medical and Dental Area, Research and Education Assembly, Kagoshima University
  • Yamada Waka
    Department of Pediatric Surgery, Research Field in Medical and Health Sciences, Medical and Dental Area, Research and Education Assembly, Kagoshima University Clinical Training Center, Kagoshima University Hospital
  • Kaji Tatsuru
    Department of Pediatric Surgery, Research Field in Medical and Health Sciences, Medical and Dental Area, Research and Education Assembly, Kagoshima University Clinical Training Center, Kagoshima University Hospital
  • Ieiri Satoshi
    Department of Pediatric Surgery, Research Field in Medical and Health Sciences, Medical and Dental Area, Research and Education Assembly, Kagoshima University

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Other Title
  • 脾固定術後に胃固定を必要とした遊走脾2症例の治療経験
  • ヒコテイ ジュツゴ ニ イ コテイ オ ヒツヨウ ト シタ ユウソウヒ2 ショウレイ ノ チリョウ ケイケン

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<p>The coexistence of wandering spleen and gastric volvulus is well known; however, it is unclear whether these conditions can be treated only by splenopexy. We experienced treating two cases of wandering spleen requiring additional gastropexy after splenopexy by the retroperitoneal pouch method. [Case 1] A 3-year-old girl showed agenesis of the splenocolonic ligament and splenorenal ligament along with stretching of the gastrosplenic ligament. The organoaxial gastric volvulus was released, and splenopexy was performed. Anorexia remained, and abdominal X-ray showed a dilated gastric bubble, so gastropexy was additionally performed on post-operative day 43. [Case 2] A 9-year-old boy showed agenesis of all four ligaments and his spleen was fixed by splenopexy. Hiccups and abdominal pain remained; assuming that insufficient gastric volvulus and spontaneous reduction recurred, gastropexy was additionally performed 337 days after the initial operation. In the two cases, performing only splenopexy of the wandering spleen did not resolve the complaints of the patients because the loose organoaxial gastric volvulus remained. Abnormality of the gastrosplenic ligament is recognized as a key substrate of gastric volvulus after the splenopexy. In the treatment of wandering spleen, simultaneous gastropexy seems desirable.</p>

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