Haematemesis revealing the chronic volvulus of a wandering spleen.

A 23 years old woman was admitted on emergency for an upper digestive tract bleeding and endoscopy found gastric varices. CT scan revealed a splenomeg aly, a twisted aspect of the splenic pedicle and varices in the gastrosplen ic ligament. Arteriography showed a narrow splenic artery and varices in th e gastrosplenic ligament. After a recurrent bleeding, splenectomy was perfo rmed. There was a chronic volvulus of a wandering spleen; the splenic venou s flow was passing through the left gastroepiploic vein and a gastrosplenic vein. Chronic volvulus of a wandering spleen with gastric varices is an un frequent pathology, diagnosed by imaging and requiring splenectomy. (C) 200 1 Editions scientifiques et medicales Elsevier SAS.