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Re: Rare case of wandering spleen causing intra‐thoracic megacolon

We value greatly the article by Han et al., which was recently published. The report demonstrated an unusual case of a wandering spleen (WS) presenting at an advanced age with symptoms of partial large bowel obstruction. The clinical presentation of WS is highly variable, from being asymptomatic to a life-threatening acute abdomen secondary to torsion, infarction or rupture. We had discovered and reported a case of WS with concomitant acute appendicitis and small bowel obstruction which ended up with splenectomy and bowel resection. There are several issues that trigger us to wonder. The authors mentioned that the patient developed dysphagia before reoperation, but other important alarming symptoms and the haemodynamic status of the patient were not described. This information is vital for us to decide whether another surgery is warranted. In figure 1, it is difficult to appreciate the right upper lobe atelectasis in contrasted soft tissue setting in coronal view. We agree that there was a significant total left lung volume reduction. Perhaps, an image in lung setting presented in coronal view would be best to showcase the atelectatic changes in the specific lobe. Besides, the intraoperative finding revealed an eventration of the diaphragm which might lead to gastric intrathoracic migration. The decision for splenectomy, gastropexy and venting gastrostomy was excellent; however, we are wondering whether additional plication of a lax diaphragmatic muscle could offer an optimistic outcome. Nevertheless, we want to congratulate the authors for describing such a rare complication of WS which was written in detail and can be used for future reference. We agree with the authors that WS should be considered as a rare cause for atypical large intestinal obstructions, especially when there is no other identifiable cause.