Torsion of the Wandering Spleen and Pancreatic Tail Precipitating Diabetic Ketoacidosis in a Patient with Prader Willi Syndrome: A Case Report


  • Wann Jia Loh Department of Endocrinology Singapore General Hospital Singapore
  • Weng Hoong Chan Senior Consultant Department of General Surgery Singapore General Hospital
  • Kwang Wei Tham Senior Consultant Director Of Life Center Department of Endocrinology Singapore General Hospital


Prader-Willi syndrome, spleen torsion, wandering spleen and diabetic ketoacidosis



Prader Willi Syndrome (PWS) includes complex endocrinological issues because of the hypothalamic and pituitary dysfunction which include obesity and diabetes, as well as behavioural issues. Other important aspects of PWS, such as hepatosplenomegaly are sometimes neglected. We present a case of diabetic ketoacidosis precipitated by torsion of a wandering spleen in a 22-year-old woman with PWS and type 2 diabetes mellitus. The pancreatic tail was involved in the torsion leading to hyperamylasaemia and pancreatitis. The splenic torsion and pancreatitis were initially treated conservatively with resolution of symptoms. A year later, she had another 2 episodes of severe abdominal pain due to worsening splenic torsion which subsided with conservative management. She subsequently underwent an elective splenectomy which revealed an enlarged and wandering spleen, with 720 degrees torsion of the long splenic pedicle.


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How to Cite

Loh, W. J., Chan, W. H., & Tham, K. W. (2016). Torsion of the Wandering Spleen and Pancreatic Tail Precipitating Diabetic Ketoacidosis in a Patient with Prader Willi Syndrome: A Case Report. Journal of the ASEAN Federation of Endocrine Societies, 31(1), 45. Retrieved from



Case Reports