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Research Article
Splenic torsion with partial colonic obstruction caused by a wandering spleen in a teenager: A case report
1 Resident-in-Training, Department of Surgery, Cotabato Regional and Medical Center, Cotabato City, Maguindanao del Norte, Bangsamoro Autonomous Region in Muslim Mindanao, Philippines
2 Medical Officer IV, Department of Surgery, Cotabato Regional and Medical Center, Cotabato City, Maguindanao del Norte, Bangsamoro Autonomous Region in Muslim Mindanao, Philippines
3 Research Consultant, Department of Surgery, Cotabato Regional and Medical Center, Cotabato City, Maguindanao del Norte, Bangsamoro Autonomous Region in Muslim Mindanao, Philippines
4 Pediatric Surgery Professor and Medical Specialist IV, Department of Surgery, Cotabato Regional and Medical Center, Cotabato City, Maguindanao del Norte, Bangsamoro Autonomous Region in Muslim Mindanao, Philippines
5 Hepatopancreatobiliary Surgery Professor and Chair, Department of Surgery, Cotabato Regional and Medical Center, Cotabato City, Maguindanao del Norte, Bangsamoro Autonomous Region in Muslim Mindanao, Philippines
Address correspondence to:
Ameerah S Mantawil
Cotabato Regional and Medical Center, Cotabato City, Maguindanao del Norte, Bangsamoro Autonomous Region in Muslim Mindanao,
Philippines
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Article ID: 100108Z04AM2025
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How to cite this article
Mantawil AS, Japzon JKM, Viray BAG, Chio LK, Romancap FK. Identification of biomarkers and enrichment analysis in pancreatic adenocarcinoma through transcriptome analysis. Int J Hepatobiliary Pancreat Dis 2025;15(2):24–31.ABSTRACT
Introduction: The wandering or ectopic spleen is a rare condition, reported only in a few case reports and small case series involving children. In wandering spleen, the spleen migrates from its normal anatomic location to another site of the abdomen due to laxity or underdeveloped supporting ligaments. The severity of clinical manifestation depends upon the degree of torsion and varies from intermittent pain to severe pain in infarction.
Case Report: This report presents a case of a young teen with chronic abdominal pain with initial work up that was unremarkable. The diagnosis remained elusive for two years and symptoms persisted. However, due to a recent increase in severity of the abdominal pain and its associated changes in bowel habit that a whole abdomen computed tomography was requested and revealed wandering spleen located in the subhepatic area at the right upper quadrant. The patient underwent diagnostic laparoscopy converted to an exploratory laparotomy with splenic detorsion, splenopexy, and colopexy. The postoperative course was unremarkable.
Conclusion: A wandering spleen is difficult to diagnose clinically as the signs and symptoms are usually mild. This patient had initially sought consult to multiple physicians and even a sonography revealed unremarkable findings hence the diagnosis remained elusive for a long time. Torsion and infarction usually occur if left untreated with high mortality rate. Along with evolving diagnostic modalities, a high index suspicion is needed to establish the proper diagnosis. This report highlights the investigation and management of the case.
Keywords: Pediatric abdominal pain, Splenic torsion, Wandering spleen
SUPPORTING INFORMATION
Acknowledgments
With profound gratitude, I extend my deepest appreciation to the individuals and institutions whose unwavering support, dedication, and contributions have been instrumental in the realization of this paper. Their collective efforts have not only shaped the success of this work but also reinforced the values of compassion, excellence, and collaboration that define our shared commitment to healthcare.
First and foremost, I express my heartfelt gratitude to the Department of Surgery at Cotabato Regional and Medical Center (CRMC). The department’s relentless pursuit of excellence in surgical care and its commitment to advancing medical practice have been the cornerstone of this achievement. Under the leadership of esteemed professionals, the Department of Surgery has consistently demonstrated innovation and expertise, as evidenced by its impactful initiatives such as the lay forum and free diagnostic examinations. These efforts highlight the department’s dedication to patient education and accessible healthcare, particularly for critical conditions, which affects thousands in the Philippines annually. The collaborative spirit of the surgical team, coupled with their technical proficiency and compassionate approach, has provided an inspiring environment that fosters both professional growth and meaningful patient outcomes. Their contributions have been pivotal in ensuring that this work aligns with the highest standards of medical practice, community service and research-guided patient care.
I am equally indebted to Cotabato Regional and Medical Center (CRMC), a Level III Apex hospital headed by Dr. Ishmael Dimaren and the only tertiary teaching and training hospital in the Bangsamoro Autonomous Region in Muslim Mindanao (BARMM) and Central Mindanao. CRMC’s vision to become a multispecialty center, has set a transformative path for healthcare delivery in the region. CRMC’s modernization efforts have created a robust platform for advanced medical interventions and research. This institutional support has been vital in providing the resources, infrastructure, and vision necessary for the success of this work. To the patient and his guardian, I owe a special debt of gratitude. Your trust, resilience, and cooperation have been the heart of this report. The patient’s courage in facing medical challenges and the guardian’s steadfast support have not only facilitated the clinical aspects of this work but also served as a profound reminder of the human element at the core of healthcare. Your willingness to share your experiences and adhere to medical recommendations has been invaluable, enabling us to achieve meaningful outcomes and reinforcing the importance of patient-centered care. Your contribution has given this work purpose and underscored the profound impact of empathy and trust in the healing process.
Lastly, I extend my deepest appreciation to my family and love one, whose unwavering love, encouragement, and sacrifices have been my anchor throughout this journey. Your understanding during long hours of work, your patience with my commitments, and your belief in my aspirations have provided me with the strength and motivation to persevere. Your emotional support has been a constant source of inspiration, reminding me of the values of perseverance and dedication that drive my professional endeavors. This work is as much a testament to your sacrifices as it is to my efforts, and for that, I am eternally grateful.
Ameerah S Mantawil - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
John Kristoffer M Japzon - Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Brent Andrew G Viray - Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Lito K KChio - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Faisal K Romancap - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2025 Ameerah S Mantawil et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
