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

@#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.

Youth/Adults

The prevalence of obesity is increasing. It is associated with conditions such as type 2 diabetes mellitus, hypertension, dyslipidaemia and non-alcoholic fatty liver disease and together with its co-morbidities, obesity has become a fast-growing public health concern and health burden. However, weight loss has been shown to reduce the development and improve these conditions. This paper looks at the epidemiology, obesity-related comorbidities, in particular pre-diabetes, and the various strategies that can be implemented to prevent and treat this looming problem.