Abdominal pain and wandering spleen in young children: the importance of an early diagnosis

Crosta, Ida Di; Inserra, Alessandro; Gil, C Pueyo; Pisani, Mara; Ponticelli, A.

doi:10.1016/j.jpedsurg.2009.02.062

Cited by 22 publications

(10 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[ 5 , 6 ] In pediatrics, most WS cases are seen in children <1 year old, which is 2.5 times more common in boys than in girls, [ 7 ] and the condition may have equal incidence rates in both sexes within the first 10 years of life. [ 8 ] After the first decade, WS predominantly occurs among females compared to males, with a ratio of 7:1. [ 9 ] However, within the younger occurring peak of WS, toddler (aged 1–3 years) WS cases are unusual.…”

Section: Discussionmentioning

confidence: 99%

“…Depending on the torsion degree, it may subsequently lead to splenic infarction, gangrene, abscess formation, peritonitis, gastrointestinal obstruction, or spleen rupture. [ 8 ] When the tail of the pancreas is partially twisted along with the vascular pedicle at the splenic hilum, it may cause pancreatitis and ischemia of the pancreatic tail. Among the toddler WS cases, 7 patients had different complications; 4 patients were diagnosed with WS combined with splenic torsion, and 2 patients’ spleen affected their stomachs (Table 1 ).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Wandering spleen with splenic torsion in a toddler

Wang¹,

Qiang²,

Huang

et al. 2020

Medicine

View full text Add to dashboard Cite

Rationale: Wandering spleen (WS) is a rare clinical entity characterized by splenic hypermobility caused by absent or abnormal laxity of the suspensory ligaments, which fix the spleen in its normal position. Due to abnormal attachment, the spleen is predisposed to torsion and a series of complications. Pediatric WS is mostly reported in children aged <10 years, especially among infants aged <1 year; it is uncommon among toddlers between 1 and 3 years. To the authors’ knowledge, only seven cases of WS have been described previously. Herein, we present the case of a 3-year-old toddler with WS and splenic torsion. Patient concerns: A 3-year-old boy was presented to the pediatric emergency room with a 2-day history of abdominal pain and vomiting. The ultrasonographic examination revealed a mass in the left upper abdomen cavity and absence of spleen in its normal position. Computed tomography showed an enlarged displaced spleen occupying the left abdomen cavity with an elongated splenic vascular pedicle (whirl sign), suggesting splenic torsion. Diagnoses: The patient was diagnosed that had WS and splenomegaly, with or without complications due to splenic torsion. Interventions: The patient underwent emergency laparotomy and splenectomy due to nonviability after detorsion. Outcomes: The postoperative course was uneventful, and the patient was discharged on the 7th day postoperatively without complications. The patient had favorable outcome over a 1-year follow-up. Lessons: Herein, we reported the case of a toddler with WS with splenic torsion. Moreover, after reviewing relevant studies in literature, we presented our findings on the diagnosis and treatment of toddlers with WS. Toddlers with WS are characterized by acute abdominal pain, unclear history description, examination restrictions, and high rates of life-threatening complications. High level of suspicion, careful physical examination, detailed history collection, and objective investigation are crucial in the management of toddlers with WS.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Wandering spleen with splenic torsion in a toddler

Wang¹,

Qiang²,

Huang

et al. 2020

Medicine

View full text Add to dashboard Cite

show abstract

“…Abdominal Doppler sonogram is the imaging examination of choice for the diagnosis of wandering spleens [4,5,21].…”

Section: Additional Imaging Examinationsmentioning

confidence: 99%

“…In the literature, we find isolated case reports but rarely studies on larger populations [1][2][3][4][5][6].…”

mentioning

confidence: 99%

Wandering spleen in children: multicenter retrospective study

Fiquet-Francois

Belouadah

Ludot

et al. 2010

Journal of Pediatric Surgery

View full text Add to dashboard Cite

“…(Fiquet-François et al, 2010;Brown et al, 2003;Di Crosta et al, 2009;Karmazyn et al, 2005). It is essential to ask the radiologists to correctly evaluate the location and viability of the spleen when faced with gastric volvulus, but also dull abdominal pain.…”

Section: Abdominal Sonogrammentioning

confidence: 99%