A Rare Complication of Gastric Volvulus in Infectious Mononucleosis: A Case Report

TL;DR

A rare case of gastric volvulus caused by infectious mononucleosis in a child was successfully treated with surgery.

Contribution

This case report highlights gastric volvulus as an extremely rare complication of infectious mononucleosis in pediatric patients.

Findings

A five-year-old girl with infectious mononucleosis developed acute gastric volvulus due to massive splenomegaly.

Laparoscopic derotation surgery resolved the condition with no complications at 12-month follow-up.

Abstract

Infectious mononucleosis (IM), typically resulting from Epstein-Barr virus infection, is characterized by the clinical triad of fever, pharyngitis, lymphadenopathy, and hepatosplenomegaly. Acute gastric volvulus secondary to massive splenomegaly represents an exceedingly rare yet life-threatening complication that requires urgent intervention. We reported the case of a five-year-old girl who was diagnosed with IM. Subsequently, the patient identified a 180° gastric volvulus associated with splenomegaly. Laparoscopic surgery derotation was promptly performed, with immediate resolution of symptoms. The patient experienced an uncomplicated recovery and remained asymptomatic at the 12-month follow-up. We presented a case of acute gastric volvulus as a rare complication of IM. This case underscores that in pediatric patients presenting with acute abdomen and splenomegaly, gastric volvulus should be considered alongside other complications such as splenic rupture. Prompt surgical evaluation is warranted when clinical suspicion arises.

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