Laparoscopic Gastropexy for the Treatment of Gastric Volvulus Associated with Wandering Spleen

被引:14
|
作者
Francois-Fiquet, Caroline [1 ]
Belouadah, Mohamed [1 ]
Chauvet, Philippe [1 ]
Lefebvre, Francis [1 ]
Lefort, Gerard [1 ]
Poli-Merol, Marie Laurence [1 ]
机构
[1] Hop Americain, Serv Chirurg Pediat, Dept Pediat Surg, F-51092 Reims, France
来源
JOURNAL OF LAPAROENDOSCOPIC & ADVANCED SURGICAL TECHNIQUES | 2009年 / 19卷
关键词
OF-THE-LITERATURE; SPLENOPEXY; CHILD;
D O I
10.1089/lap.2008.0091.supp
中图分类号
R61 [外科手术学];
学科分类号
摘要
A 2.5-year-old boy was referred to the emergency room for a sudden onset of diffuse and increasing abdominal pain with lethargy, abdominal distension, and vomiting, all in the past 24 hours. A plain abdominal X-ray showed gastric distension. Two liters of gastric contents were evacuated by suction. The abdominal sonogram showed an unusual position of the spleen in the left-lower quadrant, with no splenic ischemia. The diagnosis of gastric volvulus associated with a wandering spleen was then evoked. Laparoscopic exploration revealed a nonischemic spleen, absence of normal supporting ligaments for the spleen, and gastric distension with flaccid gastric walls. The spleen was then easily moved in the left-under quadrant. A parietal peritoneal posterolateral incision was made, opposite the large gastric curve, up to the diaphragm (7 cm). This delimitated a sharp demarcation zone between the two edges of the incised peritoneum. The stomach was fixed to the peritoneal incision, covering and anchoring the spleen in a good position. Recovery was uneventful, and an abdominal sonogram performed 4 years after the surgery shows a viable spleen in its correct location. The rarity of gastric volvulus associated with a wandering spleen and its fast clinical improvement with medical treatment often delays the diagnosis and the surgical treatment. Laparoscopy in this case has a dual relevance: diagnosis and therapeutic management (splenectomy or gastropexy). Laparoscopic gastropexy for the treatment of gastric volvulus associated with a wandering spleen is an easy procedure and combines the advantages of all the surgical techniques previously described.
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页码:S137 / S139
页数:3
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