Gastric volvulus and wandering spleen.

Although rare in childhood, gastric volvulus and wandering spleen share a common etiology: congenital absence of intraperitoneal visceral attachments. We report an unusual case of a patient who presented with three episodes of intractable vomiting and abdominal mass but no abdominal pain. A diagnosis could not be made until the third episode because the gastric volvulus resolved each time on placement of a nasogastric (NG) tube before any further tests could be done. During the third episode, diagnostic imaging was performed before inserting an NG tube, and the diagnosis of a mesenteroaxial gastric volvulus and an abnormally positioned spleen was made. Although both conditions are caused by abnormalities of fixation, the association of gastric volvulus and wandering spleen has been reported only once before.