PMC7610022_01
A: Enlarged wandering spleen. B: Viscera in left chest from CDH.
gr1.jpg
PMC7610022_01_gr1.jpg
fig0005
A CT chest, abdomen and pelvis was performed which demonstrated a 19 cm abnormally positioned spleen in the mid-abdomen (Fig. 1A). The left lung and left pulmonary artery appeared hypoplastic (Fig. 1B).
Enlarged spleen removed.
gr2.jpg
PMC7610022_01_gr2.jpg
fig0010
A splenectomy was performed (Fig. 2) by dividing the ectatic splenic pedicle with EndoGIA Tristapler  (Minneapolis, Minnesota, USA).
Intraoperative image of left posterolateral Bochdalek hernia defect.
gr3.jpg
PMC7610022_01_gr3.jpg
fig0015
Next, the abdominal viscera were reduced from the chest revealing the left posterolateral Bochdalek congenital diaphragmatic hernia (Fig. 3).
Chest X-ray prior to discharge showing re-expansion of left lung.
gr4.jpg
PMC7610022_01_gr4.jpg
fig0020
Bowel movements were slow to progress, but the patient made an otherwise unremarkable recovery with chest tube removed on day 7 and evidence of significant left lung re-expansion on chest x-ray (Fig. 4).