# Iatrogenic wandering spleen causing gastric outlet obstruction and perforation

## TL;DR

A rare iatrogenic wandering spleen caused gastric issues after surgery, requiring splenectomy and repair.

## Contribution

This is possibly the first reported case of an iatrogenic wandering spleen.

## Key findings

- A 51-year-old patient developed gastric outlet obstruction and perforation due to iatrogenic wandering spleen.
- The patient required open laparotomy and splenectomy after robotic-assisted adrenalectomy.
- Chronic steroid use and complex medical history complicated postoperative management.

## Abstract

The phenomenon of a wandering spleen is rare with few published case reports. The cases published in the literature mainly result from acquired or congenital laxity of the spleen’s anchoring ligaments. Our case demonstrates an uncommon complication and possibly the first reported case of an iatrogenic wandering spleen. We present an interesting case of a 51-year-old female patient with congenital adrenal hyperplasia, fibromyalgia, and rheumatoid arthritis who underwent robotic-assisted left adrenalectomy for a 10-cm adrenal mass. Postoperatively, she developed uncontrolled pain and gastric distension due to spleen entrapment, leading to an open laparotomy and splenectomy with gastric perforation repair. She made an uneventful recovery. The rarity of iatrogenic wandering spleen as well as our patient’s complex medical history, including chronic steroid use, presented unique challenges in postoperative management. This case highlights the importance of thorough perioperative evaluation and careful surgical planning in patients with underlying conditions.