Splenic torsion requiring splenectomy six years following laparoscopic Nissen fundoplication.
BACKGROUND
Laparoscopic Nissen fundoplication has become a mainstay in the surgical treatment of gastroesophageal reflux disease, as it has proved to be a durable, well-tolerated procedure. Despite the safety and efficacy associated with this procedure, surgeons performing this  advanced laparoscopic surgery should be well versed in the potential intraoperative and postoperative complications.


METHODS
A case is presented of a rare complication of splenic torsion following laparoscopic Nissen fundoplication. Diagnostic evaluations and intraoperative findings  are discussed.


RESULTS
We present an otherwise healthy 41-year-old woman who underwent a laparoscopic Nissen fundoplication 6 years earlier at another medical center and presented with worsening chronic left upper quadrant abdominal pain. She was diagnosed with torsion of the splenic  vascular pedicle, resulting in heterogenicity of perfusion with associated hematoma requiring open splenectomy.


CONCLUSIONS
Surgeons should be aware of splenic torsion as a potential, albeit rare, complication related to laparoscopic Nissen fundoplication.
South East Area Health Education Center, Department of Surgery, New Hanover Regional Medical Center, Wilmington, NC, USA.
Khoi
K
Le
Devan
D
Griner
William W
WW
Hope
Darryl
D
Tackett
D000063:Accidents, Traffic; D000328:Adult; D005260:Female; D018662:Fundoplication / Q000009:adverse effects* / Q000379:methods; D005764:Gastroesophageal Reflux / Q000601:surgery; D006801:Humans; D010535:Laparoscopy; D013154:Spleen / Q000000981:diagnostic imaging; D013156:Splenectomy; D013158:Splenic Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D014102:Torsion Abnormality / Q000000981:diagnostic imaging / Q000601:surgery*; D050805:Wandering Spleen / Q000150:complications* / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery