Intrathoracic volvulus of the spleen revealing left posterolateral diaphragmatic hernia

Background: Late-recognized congenital left diaphragmatic hernia may have a bad prognosis when it is revealed by perforation or volvulus of the herniated viscera.

Methods: A 20 month-old boy was admitted for vomiting and abdominal pain. X-rays showed left diaphragmatic hernia and the patient was operated on with the diagnosis of volvulus of the stomach. Surgery showed hernia through the posterolateral segments of the diaphragm with spleen volvulus into the sac, requiring splenectomy before reduction of the hernia and closure of the diaphragmatic defect.

Conclusions: This is the fifth report of ectopic intrathoracic spleen with volvulus revealing congenital left diaphragmatic hernia.