Is laparoscopic approach for wandering spleen in children an option?

Alqadi, Gratiana Oana; Saxena, Amulya K.

doi:10.4103/jmas.jmas_14_18

Cited by 16 publications

(4 citation statements)

References 17 publications

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“…However, if there is no blood flow to the spleen even after detorsing, a splenectomy is performed. 4 At the time of our patient's presentation, the spleen was completely infarcted with evidence of ischemia on CT scan. The likelihood of return flow to the spleen was deemed unlikely.…”

mentioning

confidence: 80%

Wandering Spleen

Nafash¹,

Azubuine²

2019

Journal of Education and Teaching in Emergency Medicine

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mentioning

confidence: 80%

Wandering Spleen

Nafash¹,

Azubuine²

2019

Journal of Education and Teaching in Emergency Medicine

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“…The other presentations are usually related to the mass effect of the enlarged spleen and patients could present with GOO, bowel obstruction, pancreatitis and urinary symptoms [3,6]. • In some cases it is reported to be associated with some other disorders like gastric volvulus [7] and distal pancreatic volvulus [8]. • Ultrasound is one of the imaging modalities to investigate patients whom we suspect had wandering spleen.…”

Section: Managementmentioning

confidence: 99%

“…• Partial infraction of a wandering spleen might necessitate partial splenectomy and splenopexy or splenectomy and splenic implantation [6,11]. • The spleen might get fixed by different methods [8,9]. Fig.…”

Section: Managementmentioning

confidence: 99%

Wandering spleen presenting in the form of right sided pelvic mass and pain in a patient with AD-PCKD: a case report and review of the literature

shibiru,

wondimu,

almaw

2024

J Med Case Reports

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Background Wandering spleen is a rare clinical entity in which the spleen is hypermobile and migrate from its normal left hypochondriac position to any other abdominal or pelvic position as a result of absent or abnormal laxity of the suspensory ligaments (Puranik in Gastroenterol Rep 5:241, 2015, Evangelos in Am J Case Rep. 21, 2020) which in turn is due to either congenital laxity or precipitated by trauma, pregnancy, or connective tissue disorder (Puranik in Gastroenterol Rep 5:241, 2015, Jawad in Cureus 15, 2023). It may be asymptomatic and accidentally discovered for imaging done for other reasons or cause symptoms as a result of torsion of its pedicle and infarction or compression on adjacent viscera on its new position. It needs to be surgically treated upon discovery either by splenopexy or splectomy based on whether the spleen is mobile or not. Case presentation We present a case of 39 years old female Ethiopian patient who presented to us complaining constant lower abdominal pain especially on the right side associated with swelling of one year which got worse over the preceding few months of her presentation to our facility. She is primiparous with delivery by C/section and a known case of HIV infection on HAART. Physical examination revealed a right lower quadrant well defined, fairly mobile and slightly tender swelling. Hematologic investigations are unremarkable. Imaging with abdominopelvic U/S and CT-scan showed a predominantly cystic, hypo attenuating right sided pelvic mass with narrow elongated attachment to pancreatic tail and absent spleen in its normal position. CT also showed multiple different sized purely cystic lesions all over both kidneys and the pancreas compatible with AD polycystic kidney and pancreatic disease. With a diagnosis of wandering possibly infarcted spleen, she underwent laparotomy, the finding being a fully infarcted spleen located on the right half of the upper pelvis with twisted pedicle and dense adhesions to the adjacent distal ileum and colon. Release of adhesions and splenectomy was done. Her post-operative course was uneventful. Conclusion Wandering spleen is a rare clinical condition that needs to be included in the list of differential diagnosis in patients presenting with lower abdominal and pelvic masses. As we have learnt from our case, a high index of suspicion is required to detect it early and intervene by doing splenopexy and thereby avoiding splenectomy and its related complications.

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“…A mi eseteinkben három különböző technikát választottunk a lép rögzítésére. Korábban egyértelműen a nyitott műtéti technika volt jellemző, a mai trendek azonban egyre inkább a minimálinvazív technikák felé mutatnak [14]. Az első laparoszkópos splenopexiát Hirose és mtsai publikálták 1998-ban, azóta egyre szélesebb körben alkalmazzák világszerte [15].…”

Section: Megbeszélésunclassified

Vándorlép csavarodása gyermekkorban – 3 eset ismertetése

Rónaky,

Farkas,

Lazáry

et al. 2024

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A vándorlép gyermekkorban ritkán előforduló fejlődési rendellenesség, melynek lényege, hogy a lépet a has bal felső kvadránsában rögzítő szalagok vagy lazák, vagy hiányoznak. Ez az anatómiai környezet kedvez a lépcsavarodásnak, mely a leggyakoribb szövődmény vándorlép esetén. Ammenyiben vándorlép igazolódik, műtétre van szükség. Két műtéti stratégia közül választhatunk: megtartjuk és fixáljuk, vagy egyértelmű infarktus esetén eltávolítjuk a lépet. A szerzők egy 16 éves periódust (2004–2020) tekintenek át, amelynek során két intézetben három gyermeket kezeltek lépcsavarodás miatt. A hasi panaszok kezdetétől 12–48 órán belül történt hasi ultrahangvizsgálat. A gyermeksebészeti vizsgálatok előtt a gyermekek székrekedés gyanúja miatt mindhárom esetben béltisztító kezelést kaptak, mivel az első észlelők a vándorlépet kitapintva skybalának tartották. A képalkotó vizsgálatok ectopiás helyen lévő lépet igazoltak, és felvetették a lépcsavarodás gyanúját. Nyitott műtét során mindhárom esetben lépmegtartó műtét történt. Posztoperatív szövődmény nem alakult ki. A megtartott lépek életképességét illetően nyomon követéses vizsgálatok történtek. Orv Hetil. 2024; 165(22): 866–871.

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Is laparoscopic approach for wandering spleen in children an option?

Cited by 16 publications

References 17 publications

Wandering Spleen

Wandering Spleen

Wandering spleen presenting in the form of right sided pelvic mass and pain in a patient with AD-PCKD: a case report and review of the literature

Vándorlép csavarodása gyermekkorban – 3 eset ismertetése

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