Acute Torsion of Wandering Spleen: Report of One Case

Abstract

Wandering spleen is a rare condition that can lead to splenic infarction or rupture if torsion persists. Early diagnosis and intervention are necessary, and abdominal ultrasonography and abdominal computed tomography are well accepted as the diagnostic imaging modalities. In this study, we present a boy with nic infarction due to acute torsion of a wandering spleen, after initial failure to demonstrate an ectopic spleen. Instead, acute torsion of the wandering spleen with spontaneous partial detorsion was incidentally found by multi-detector row CT with angiography. The patient was managed by splenectomy instead of splenopexy, because poor reperfusion after Laparoscopic detorsion.

Emergency laparoscopic splenectomy for torsion of wandering spleen in a geriatric patient: A case report

“…Most patients with WS are asymptomatic [10]. Commonly, WS is detected incidentally in physical examination as an abdominal mass or in imaging studies performed for other conditions [3,[6], [7], [8],[12], [13], [14]]. Paediatric WS patients usually present with acute abdominal pain, whereas abdominal mass is the most common complaint in adult WS patients [6].…”

“…Due to the non-pathognomonic history and clinical manifestation, radiological modalities are paramount in attaining a definitive diagnosis [1,3,5,6,[9], [10], [11], [12], [13], [14]]. Imaging studies provide vital information, such as splenic blood flow and viability to aid in management planning [3,7,11].…”

“…Clinical presentations vary from asymptomatic incidental discovery to a life-threatening acute abdomen [1,2,8,10,11]. Imaging modalities can aid in diagnosis and assessment [[1], [2], [3][5], [6], [7], [8], [9], [10][12], [13], [14]]. A WS is managed surgically with a splenopexy or splenectomy, using a laparotomy or laparoscopic approach [[1], [2], [3], [4],[6], [7], [8], [9], [10], [11], [12], [13], [14]].…”

Spontaneous Splenic Rupture in Melanoma

“…Melanocytes are normally present in skin, being responsible for production of the dark pigment melanin. According to some of the previous reports, melanoma causes splenomegaly and in rare instances spontaneous splenic rupture [2, 3]. …”

“…Spontaneous splenic rupture as the first presentation of metastatic melanoma to the spleen is very rare [3, 5]. Despite the high incidence of splenic metastases in metastatic melanoma, there have been very few cases of spontaneous splenic rupture reported in the literature [2].…”