Acute torsion of the spleen: diagnosis and management

Vázquez, José Luís; Montero, Margarita; Díaz, Florentino; Muguerza, R; Páramo, C.; Rodríguez-Costa, Alberto

doi:10.1007/s00383-003-1110-6

Cited by 5 publications

(9 citation statements)

References 9 publications

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“…3 The laxity or absence of its supporting ligaments is believed to be either congenital, secondary to abnormal development of the dorsal mesogastrium, or acquired, in conditions such as splenomegaly or abdominal trauma. 4 Acute, chronic or intermittent torsion of the spleen is the major complication of an abnormally mobile spleen. 5 The clinical presentation of torsion of the spleen is variable.…”

Section: Discussionmentioning

confidence: 99%

“…5 Pain is due to capsular stretching from venous stasis and congestion. 4 Patients may complain of nausea, vomiting or fever, and may be peritonitic on examination. Blood tests may reveal raised inflammatory markers.…”

Section: Discussionmentioning

confidence: 99%

“…Haematemesis, splenic abscess, pancreatitis, or gastric volvulus may also be seen. 4 A relationship between kyphoscolisis of the spine and a wandering spleen has not been documented in the literature.…”

Section: Discussionmentioning

confidence: 99%

“…4 Management is guided by the clinical scenario. A wandering spleen can be managed conservatively or with elective laparoscopic or open splenopexy.…”

Section: Discussionmentioning

confidence: 99%

“…An acute abdomen would require surgical intervention. Preservation of the spleen is the goal, as risk of post-splenectomy sepsis is high, 4 although total splenectomy is the treatment modality of choice for an infarcted spleen followed by vaccinations and life-long antibiotic prophylaxis according to institutional protocol.…”

Section: Discussionmentioning

confidence: 99%

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Splenic torsion: a case report

Hussain

Deshpande

Bailey

2010

annals

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Introduction Torsion of the spleen is a rare cause of abdominal pain. Predisposition occurs following abnormal development of splenic suspensory ligaments. We report a case of splenic torsion in a spleen sited in a normal anatomical position and discuss the latest treatment options. To the best of our knowledge, this has not been reported in the literature to date. Case Presentation A 73-year-old Caucasian woman presented to our department with sudden onset, severe, left-upper abdominal pain. An enhanced computed tomography revealed an unenhancing spleen. She underwent an urgent laparotomy and splenectomy for 360° torsion of her spleen. Conclusions Splenic torsion in a wandering spleen has been described with an incidence of < 0.2%. Symptoms vary from asymptomatic to an acute surgical abdomen. Diagnosis is commonly made using colour Doppler sonography or enhanced computed tomography. Surgery is guided by clinical setting, with preservation of the spleen as the goal.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…4 Management is guided by the clinical scenario. A wandering spleen can be managed conservatively or with elective laparoscopic or open splenopexy.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Splenic torsion: a case report

Hussain

Deshpande

Bailey

2010

annals

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Splenic Autotransplantation for a Congested and Enlarged Wandering Spleen with Torsion: Report of a Case

et al. 2006

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In children with diseases of the spleen, every effort should be made to preserve the organ, to prevent severe infections postsplenectomy. We report the case of a 7-year-old girl with torsion of a wandering spleen who we treated by autotransplantation of splenic tissues following splenectomy, when fixation of the enlarged spleen seemed impossible. Spleen scintigraphy showed uptake in the regenerating splenic tissues 9 months after surgery, and evidence of an increase in the size of the tissues 23 months after surgery. Howell-Jolly bodies had disappeared by 16 months after surgery. These findings suggested that the transplanted splenic tissues were resuming splenic functions. Based on our experience with this case, we conclude that autotransplantation after splenectomy is a treatment option for wandering spleen with torsion when fixation seems difficult because of splenic congestion and enlargement.

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