Laparoscopic splenectomy for a wandering spleen with resultant splenomegaly and gastric varices

Chue, Koy Min; Tan, Jiajie; Pang, Natalie; Kow, Alfred Wei Chieh

doi:10.1111/ans.15737

Cited by 5 publications

(2 citation statements)

References 9 publications

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“…Gastric volvulus may also be replaced without further gastropexy [11]. Although rare, gastric varices or variceal bleeding may occur in patients with splenic torsion, and can be aggravated by the coexisting gastric volvulus, namely left-sided portal hypertension [41,42]. This is caused by splenic vein occlusion (torsion and/or thrombosis), which leads to the blood outflow of spleen retrograde filling the short gastric veins, left gastric vein, and left gastro-epiploic vein [43].…”

Section: Discussionmentioning

confidence: 99%

Diagnosis and treatment of splenic torsion in children: preoperative thrombocytosis predicts splenic infarction

Wang

Peng

et al. 2022

BMC Pediatr

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Background Pediatric splenic torsion is a rare entity, and the most common cause is wandering spleen. This study aimed to summarize our clinical experience in the diagnosis and surgical treatment pediatric patients with splenic torsion, and to use preoperative thrombocytosis as a preoperative predictive factor for splenic infarction. Methods From January 1st, 2016 to December 31st, 2021, 6 children diagnosed as splenic torsion were included. All patients were surgically treated and followed up. The clinical data was collected including clinical presentations, laboratory tests, imaging results, surgical procedures, and prognosis. Clinical experience of diagnosis and surgical treatment were summarized. Results There were 4 females and 2 males, with median age at surgery 102.6 (range 9.4–170.7) months. Abdominal pain and abdominal mass were the most common presentations. The diagnosis of splenic torsion depended on imaging studies, and adjacent organ involvement (gastric and pancreas torsion) was observed on contrast CT in one patient. Five patients were diagnosed as torsion of wandering spleen, and one was torsion of wandering accessory spleen. Emergent laparoscopic or open splenectomy was performed in all patients. Pathology revealed total splenic infarction in 4 patients, partial infarction in 1 patient, and viable spleen with congestion and hemorrhage in 1 patient. Preoperative platelet counts were elevated in all 4 patients with splenic infarction, but normal in the rest 2 with viable spleen. Postoperative transient portal vein branch thromboembolism occurred in one patient. Conclusions Imaging modalities are crucial for the diagnosis of pediatric splenic torsion and adjacent organ involvement. Preoperative thrombocytosis may predict splenic infarction. Spleen preserving surgery should be seriously considered over splenectomy in patients with a viable spleen.

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Section: Discussionmentioning

confidence: 99%

Diagnosis and treatment of splenic torsion in children: preoperative thrombocytosis predicts splenic infarction

Wang

Peng

et al. 2022

BMC Pediatr

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“…As a result of an absence or loosening of these splenic ligaments, the spleen could move to other parts of the abdomen and rotate by itself. This condition is very rare, with an incidence of less than 0.2% [2], and makes susceptible the spleen to acute torsion and infarction with splenic vein obstruction, leading to the formation of gastric varices [3]. Although many conservative treatment options have been reported for the treatment of wandering spleen, the most effective and safest option is accepted to be surgery [4].…”

Section: Introductionmentioning

confidence: 99%

Torsion of a Wandering Spleen Treated by Laparoscopic Surgery: A Case Report

Cho

2021

Soonchunhyang Med Sci

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The spleen is an organ located in the upper left portion of the abdomen. Wandering spleen is defined as the location of the spleen is the shift to other parts of the abdomen rather than the left upper quadrant. Wandering spleen is a rare clinical condition and can lead to hilar torsion and subsequent infarction requiring emergency surgery. The author presents a case of torsion of a wandering spleen in a 34-year-old female presenting with abdominal pain. The patients underwent emergent laparoscopic splenectomy. She had an uncomplicated postoperative course and recovered well.

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Imaging Manifestations of Wandering Spleen With Torsion

Chen

Qin

et al. 2023

The Journal of Emergency Medicine

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Laparoscopic splenectomy for a wandering spleen with resultant splenomegaly and gastric varices

Cited by 5 publications

References 9 publications

Diagnosis and treatment of splenic torsion in children: preoperative thrombocytosis predicts splenic infarction

Diagnosis and treatment of splenic torsion in children: preoperative thrombocytosis predicts splenic infarction

Torsion of a Wandering Spleen Treated by Laparoscopic Surgery: A Case Report

Imaging Manifestations of Wandering Spleen With Torsion

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