Diagnosis of wandering spleen by computed tomography multislice

Ahoury, N’guessan Judicael; N’Zi, K.P.; Kouamé, K.; Salami, F.A.; Diabate, AS; A, Seka

doi:10.1007/s12157-016-0667-3

Cited by 1 publication

(5 citation statements)

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“…Ectopic spleen is rare, less than 0.5% of several large series splenectomies [1,2]. It exists at any age, with predominance at male children under 10 years old, at women during genital activity period, between 20 and 40 years of age [1,6], at the third decade of life, and at patient without particular medical history [1,4,5,7,8]. Only intraperitoneal localization is described, with hypogastric or pelvic predilection [4].…”

Section: Discussionmentioning

confidence: 99%

“…Congenital drifting spleen is due to the lack, uncompleted development or laxitude of the dorsal mesogastrium suspensory ligaments [2,7,9]. Acquired forms may be due to gastric distention, splenomegaly, abdominal hyperlaxity or weakness of the abdominal wall tone, abdominal injury, or hormonal change during pregnancy and multiparity [4,5,10]. Ectopic spleen can be associated with accessory spleen in 10% of cases [9].…”

Section: Discussionmentioning

confidence: 99%

“…Wandering spleen may remain asymptomatic for a long time, or presents abdominal discomfort [1]. Then, it will be discovered in many variable circumstances, dominated by torsion complication's expression as abdominal, pelvic or peri-umbilical intermittent pain, or unfortunately during a complementary examination performed for other pathology [4,5,8]. Nausea, vomiting, fever, or splenomegaly can also go with torsion [2,7].…”

Section: Discussionmentioning

confidence: 99%

“…In tropical countries as Madagascar, these signs can bring confusion with parasitic splenomegaly, abdominal-pelvic tumor, chronic volvulus or a compressive obstructive syndrome [5,12]. General state alteration, anemia from hypersplenism, and toxi-infection's signs can occure in the severe form [4,12].…”

Section: Discussionmentioning

confidence: 99%

“…Issued to embryonic development, splenophrenic and splenoomental ligaments are inconstant, but gastrosplenic, splenorenal and splenocolic ligaments never exist in wandering spleen [1][2][3]. Its migration, congenital or acquired, to any quadrant of the abdomen or pelvis depends on the length of its pedicle [4,5]. The interest of this observation is to report a new typical case and to recall and to discuss the diagnostic and surgical approach with the litterature.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Diagnosis and Management’s Distinctive Features of an Ectopic Spleen in a Precarious Country

Rakotomen¹,

Razafimanjato²,

Razafindraibe³

et al. 2019

EJCBS

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Abdominal or pelvic ectopic spleen or wandering spleen or drifting spleen is extremely rare. It is a consequence of congenital or acquired laxity of this organ's attachment to the diaphragmatic dome, especially the suspensor ligament. The authors report a new typical case of this pathology in a 27-year-old woman, having came to consultation for painfull pelvic mass in the Joseph Ravoahangy Andrianavalona University Hospital Center in Antananarivo Madagascar, which is a precarious country. The positive diagnostic of this pathology and its surgical approach are often limited by the locally available tools and the financial accessibility of the patient to them. Ultrasonography and Computed Tomography imaging show the emptiness of the splenic lodge, localize the spleen with its size, and precise its vascularisation's pathway. The symptoms are naturally latent until complication appears. Surgery is more formally indicated in case of complication or because of the risk of confusion with parasitic splenomegaly which has a high prevalence in a tropical country as Madagascar. Splenopexy can exposes to more recurrences, systemacic splenectomy can expose to risks of more postoperative infection even it is more practiced. As proposed in the literature, laparoscopy could and should be developed because it does not have any eventful recovery.

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