Splenectomy for Torsion of a Wandering Spleen in a Patient with Myeloproliferative Disease

Abstract

We herein report a rare case of torsion of a wandering spleen in a patient with myeloproliferative disease. A 66-year-old Japanese woman presented to our hospital with abdominal pain and a fever. She had a medical history of polycythemia and secondary myelofibrosis. Abdominal enhanced computed tomography showed an enlarged spleen without enhancement in the lower pelvic region. The clinical diagnosis was severe torsion of a wandering spleen in a patient with myeloproliferative disease, necessitating surgical intervention. Splenectomy was performed after de-rotating to revascularize the spleen. After the operation, the platelet count gradually increased, and aspirin was administered to prevent thrombosis.

Splenic torsion in a cat with chronic anemia

“…Causes of PST in other species include inflammatory disease states, splenic ligamental laxity as a congenital abnormality (wandering spleen) or acquired due to gastric dilation (large-breed dogs), neoplasia or peritonitis, accessory splenic tissue and trauma. 3,4,12,13 As PST has not been described clinically in cats, conclusions regarding the specific etiology in this case are unavailable. Chronic use of corticosteroids could be a risk factor for gastrosplenic laxity, 14,15 but use is common in cats while splenic torsion appears exceedingly rare.…”

“… 1 , 2 Ultrasonographic findings in dogs and humans include free abdominal fluid, splenomegaly, heterogeneous parenchyma, coarse ‘lacy’ hypoechogenicity and lack of splenic vessel flow on Doppler. 2 , 3 , 8 – 11 Hyperechoic abdominal fat and pancreatitis have been seen in dogs. 9 , 10 Ultrasonographic changes described here compare with findings in dogs; however, the description in this case was limited without archived imaging available for review.…”

“…Human splenic torsion is associated with 'wandering spleen', a congenital disorder, with weakness or absence of splenic ligaments, allowing excess splenic movement. 3,4 The first case of wandering spleen without torsion in a non-human mammal was reported in a cat with gastrointestinal (GI) lymphoma. 5 In cats, splenic disease is not commonly recognized.…”