Nissen fundoplication is a generally accepted treatment for severe gastro-oesophageal reflux after conservative management has failed. The surgical techniques and the complications that may develop following the operation have been well described. However, necrosis of the spleen is a rare complication. We report here a patient with Down syndrome with a vanishing spleen after a Nissen fundoplication, who died of overwhelming pneumococcal septic shock 7 months after the operation. Vascular anomaly in Down syndrome, inadvertent ligation of the splenic artery or volvulus of the spleen may have caused a compromised splenic arterial circulation.Conclusion Nissen fundoplication may be associated with vanishing spleen and, consequently, with devastating consequences.
Dijkman, K. P., van Heurn, L. W., Leroy, P. L., & Vos, G. D. (2009). Vanishing spleen after Nissen fundoplication: a case report. European Journal of Pediatrics, 168(3), 355-357. https://doi.org/10.1007/s00431-008-0752-8