[Acute abdomen due to a solitary diverticulum].
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Wandering spleen is a rare condition characterized by increased splenic mobility due to the absence or laxity of its suspensory ligaments that may present as acute abdomen when it is twisted on its pedicle. Herein we report a case of torsion of a wandering spleen in a 17-year-old male patient with communicating hidrocephalus and ventriculoperitoneal shunt. The patient presented with suspicious clinical findings of acute abdomen, a laparotomy was performed and the infarcted spleen was removed. Although wandering spleen is a rare clinical entity, the possibility of torsion should be kept in mind in the differential diagnosis of acute abdomen.
The diagnostic work up of an acute abdomen may be more difficult in pregnant than in non-pregnant women due to the normal anatomical and physiological changes that occur during pregnancy. Delayed diagnoses and treatment may have more serious consequences for pregnant women than for other patients. We report the cases of two pregnant women, one with a volvulus of the small intestine and the other with a perforated appendix. We discuss important aspects of the diagnostic work up for acute abdomen with surgical etiology in pregnant women. If a surgical etiology is suspected in a pregnant women with acute abdominal pain, the patient should be examined and followed closely both by a surgeon and a gynaecologist until a final diagnosis is reached.
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