Prune belly syndrome, splenic torsion, and malrotation: A case report

Sifrance Tran, Eric Grossman, Katherine A. Barsness

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

An 18 year old male with a history of prune belly syndrome (PBS) presented with acute abdominal pain and palpable left upper quadrant mass. Computed tomography (CT) of the abdomen revealed a medialized spleen with a "whirl sign" in the splenic vessels, consistent with splenic torsion. Coincidentally, the small bowel was also noted to be on the right side of the abdomen, while the colon was located on the left, indicative of malrotation. Emergent diagnostic laparoscopy confirmed splenic torsion and intestinal malrotation. Successful laparoscopic reduction of the splenic torsion was achieved, however, conversion to an open procedure by a vertical midline incision was necessary owing to the patient's unique anatomy. Open splenopexy with a mesh sling and Ladd's procedure were subsequently performed. Malrotation and wandering spleen are known, rare associated anomalies in PBS; however, both have not been reported concurrently in a patient with PBS in the literature. In patients with PBS, acute abdominal pain, and an abdominal mass, high clinical suspicion for gastrointestinal malformations and prompt attention can result in spleen preservation and appropriate malrotation management. We present a case of a teenager who presented with a history of PBS, acute abdominal pain, and a palpable abdominal mass. The patient was found to have splenic torsion and intestinal malrotation. The clinical findings, diagnostic imaging, and surgical treatment options of splenic torsion are reviewed.

Original languageEnglish (US)
JournalJournal of Pediatric Surgery
Volume48
Issue number2
DOIs
StatePublished - Feb 2013
Externally publishedYes

Fingerprint

Prune Belly Syndrome
Acute Pain
Abdominal Pain
Abdomen
Wandering Spleen
Spleen
Conversion to Open Surgery
Diagnostic Imaging
Laparoscopy
Anatomy
Colon
Tomography

Keywords

  • Ladd's procedure
  • Malrotation
  • Prune belly syndrome
  • Splenic torsion
  • Splenopexy
  • Wandering spleen

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health

Cite this

Prune belly syndrome, splenic torsion, and malrotation : A case report. / Tran, Sifrance; Grossman, Eric; Barsness, Katherine A.

In: Journal of Pediatric Surgery, Vol. 48, No. 2, 02.2013.

Research output: Contribution to journalArticle

Tran, Sifrance ; Grossman, Eric ; Barsness, Katherine A. / Prune belly syndrome, splenic torsion, and malrotation : A case report. In: Journal of Pediatric Surgery. 2013 ; Vol. 48, No. 2.
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