PMC3863963_01
Plain abdominal radiography. A pre-laparoscopic image. An enlarged stomach is observed in the left lower abdomen. The upper third of the stomach appears beak shaped in a superior direction (short white arrow).
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Plain abdominal radiography revealed an enlarged stomach in the left lower abdomen (Fig. 1).
Coronal view of a contrast-enhanced computed tomographic image of the abdomen. (a) The spleen (Sp) is positioned in the midline of the pelvic area. The splenic parenchyma appears homogeneous. The ascending colon (AC) has shifted under the left diaphragm. The small intestine (Sm) appears in the right lower abdominal cavity. The stomach is twisted mesenteroaxially, with the antrum (An) positioned higher than the fundus (Fu). The white arrow heads show the connection from the shifted pylorus to the duodenum. (b) A slice obtained further posterior in the same series as (a). The white arrows show the connection from the shifted fundus of the stomach (Fu) to the cardia (Ca) and esophagus (Eso). The lower inferior vena cava (IVC) runs to the left of the aorta. (c) The schema of the wandering spleen, gastric volvulus, and intestinal malrotation in the presented case. AC, ascending colon; An, antrum of stomach; Ca, cardia; Duo, duodenum; Eso, esophagus; Fu, fundus of stomach; Py, pylorus; Sm, small intestine; Sp, spleen.
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Computed tomography (CT) demonstrated a normal-sized spleen in the midline of the pelvic region (Fig. 2). The distal inferior vena cava and superior mesenteric vein ran to the left of the aorta and superior mesenteric artery, respectively (Fig. 2).   