Contrast-Enhanced Computed Tomography Findings of the Torsioned Wandering Spleen: A Case Report

Özçağlayan, Ömer; Özçağlayan, Tuğba İ̇lkem Kurtoğlu; Gülek, Bozkurt

doi:10.14744/semb.2017.07379

Cited by 1 publication

(1 citation statement)

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“…While ultrasound is often the first radiological modality used in most cases, multi-slice spiral CT is more accurate, especially for early detection. Moreover, CT clearly establishes the heterogeneity or homogeneity of the spleen parenchyma and the organ’s arterial and venous vascularization [ 11 – 13 ]. Since a Doppler ultrasound, often, reveals a heterogenous, hypoechoic mass with specks of calcifications in the periumbilical region as noted in our patient, this could be confused for an ovarian cyst, especially if the radiologist performing the U/S does not have this differential in mind.…”

Section: Discussionmentioning

confidence: 99%

Splenic torsion mistaken for an ovarian cyst: a case report

Ahmed,

Iqbal,

Batool

et al. 2024

J Med Case Reports

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Background Wandering spleen (or ectopic spleen) refers to a hyper-mobile spleen resulting in its displacement from the normal anatomical position to usually in the lower abdominal or pelvic cavity. While ultrasound is often the first radiological modality used, Computed Tomography (CT) shows a clear picture and aides to reach a diagnosis. In circumstances where appropriate imaging modalities are not available, or the operator is inexperienced, diagnosis of wandering spleen can be missed. Case presentation A 22-nulligravida unmarried Sindhi female had presented to the Emergency Room (ER) with a 5-day history of intermittent severe lower abdominal pain. An ultrasound at a local practitioner had suggested an ovarian cyst. Ultrasound-pelvis and later CT scan at our facility reported an enlarged wandering spleen with torsion of its pedicle and infarction. Exploratory laparotomy with splenectomy was done. An enlarged wandering spleen was found with torsion of the splenic vein and thrombosed arterial supply from omentum wrapped over the mass. The patient developed thrombocytosis post-surgery but otherwise did well and was discharged after 2 days. Conclusion Splenic torsion secondary to a wandering spleen can be challenging to diagnose, especially in resource limited settings where ultrasound might be the only modality available. Timely diagnosis and proper intervention are key to saving the life and the spleen.

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Section: Discussionmentioning

confidence: 99%