Torsion of wandering spleen treated by laparoscopic splenopexy: A case report

Awan, Mariyem; Gallego, Jose Luis; Hamadi, Annett Al; Vinod, Vijay Chander

doi:10.1016/j.ijscr.2019.06.040

Cited by 22 publications

(24 citation statements)

References 13 publications

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“…The best and easiest procedure for splenopexy is Bardenheuer's procedure, where the spleen lies in the retroperitoneal pouch with the body hanging from the tenth rib and the pedicle attached to the peritoneal incision [ 6 ]. After the advancement in laparoscopic abdominal surgeries, the new gold standard is laparoscopic splenopexy, when the wandering spleen is of normal size, not infarcted, and has no signs of hypersplenism [ 14 ]. The sandwich technique where two meshes are used to sandwich the spleen is described in the literature for laparoscopic splenopexy [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

Torsion of the wandering spleen as an abdominal emergency: a case report

Masroor

Sarwari

2021

BMC Surg

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Background Wandering spleen is a rare clinical entity with a less than 0.2% reporting incidence rate. In this case, the spleen is present abnormally in the abdominal or pelvic cavity instead of its normal anatomical location. The aetiology is either congenital or acquired. The condition is caused by the absence or maldevelopment of the spleen's suspensory ligaments, which holds the spleen static in the left hypochondrium. Case presentation A 27-year-old female patient presented to the emergency department with complaints of abdominal pain, fever, nausea, vomiting, and constipation for three days. A palpable movable mass was found during the physical examination, and torsion of the wandering spleen’s pedicle was confirmed by CT scan. Open splenectomy was performed, and the patient was recovered uneventfully. Conclusion Even though ectopic spleen is a rare disease, clinicians should be aware of its incidence. Early diagnosis in the case of an acute abdomen is vital for the preservation of the spleen. Patients presented with acute abdomen and absence of splenic shadow under left hemidiaphragm should be suspected, and further radiological investigation will confirm the diagnosis. Surgery is the gold standard for wandering spleen with either splenopexy or splenectomy, depending on the spleen's condition during surgery.

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Section: Discussionmentioning

confidence: 99%

Torsion of the wandering spleen as an abdominal emergency: a case report

Masroor

Sarwari

2021

BMC Surg

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“…Pelvic and abdominal ultrasonography enhanced by power Doppler, magnetic resonance imaging (MRI), computed tomography (CT), and angiography can provide valuable information and lead to a specific diagnosis [10]. Abdominal ultrasonography may reveal a comma-shaped spleen in an ectopic location and an absence of splenic tissue in the left hypochondrium [11]. Doppler sonography can accurately estimate blood flow in the splenic vasculature and confirm the suspected torsion.…”

Section: Discussionmentioning

confidence: 99%

Wandering Spleen: A Rare Case of an Adnexal Lesion

Vlastarakos

Rouvali

Giourga

et al. 2021

Cureus

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The wandering spleen (WS) is a rare condition in which the spleen is not found in its usual location in the left hypochondrium but is positioned in the lower abdomen or the pelvis. This is a case of a 21-year-old woman who presented with chronic, intermittent, and subtle pain in the left lower quadrant of her abdomen. After clinical examination and ultrasound evaluation, an adnexal lesion was detected in the left lumbar area, and no splenic tissue was found in the left hypochondrium. The wandering spleen should be included in the differential diagnosis when encountering a patient with non-typical or acute abdominal pain. Accurate diagnostic evaluation can be performed with low-cost imaging modalities such as Doppler ultrasound.

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“…Doppler sonography may show an ectopic spleen and is useful for identifying the vascular flow 3 . However, a CT scan with intravenous contrast is considered the best option to investigate the condition and may show the position and viability of the spleen 3,6,12,16 . It also shows the characteristic sign of a "whirled appearance" of the splenic pedicle 2,9 .…”

Section: Discussionmentioning

confidence: 99%

“…Wandering spleen (WS), also called ectopic spleen, is a rare medical condition caused by laxity or absence of the splenic ligaments with congenital or acquired etiology [1][2][3][4] . It leads to migration of this organ from its anatomical location.…”

Section: Introductionmentioning

confidence: 99%

Wandering spleen as a cause of sinistral portal hypertension

Piltcher-da-Silva¹,

Costa²,

Losekann³

et al. 2021

CBR

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Wandering spleen (WS) is a rare entity characterized by laxity of peritoneal ligaments that hold the spleen stationary. It is most commonly diagnosed in children and young women. Clinical presentation ranges from asymptomatic to acute abdomen. A 19-yearold woman came to the emergency department with history of progressive abdominal pain. She also had previous episodes of hematemesis. A computed tomography scan showed an ectopic spleen with a "whirlpool sign." Laparotomy and splenectomy were performed. WS is characterized by a long vascular pedicle and laxity of peritoneal attachments of the spleen. The etiology is usually congenital. Splenopexy is the main treatment; however, splenectomy is indicated when splenic infarction is present. Despite being rare, this condition may be considered in some cases of abdominal pain. An earlier diagnosis would have allowed us to perform a splenopexy, thus reducing morbidity.

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Torsion of wandering spleen treated by laparoscopic splenopexy: A case report

Abstract: Highlights Wandering spleen. Laparoscopic splenopexy. Torsion of splenic pedicle.

Cited by 22 publications

References 13 publications

Torsion of the wandering spleen as an abdominal emergency: a case report

Torsion of the wandering spleen as an abdominal emergency: a case report

Wandering Spleen: A Rare Case of an Adnexal Lesion

Wandering spleen as a cause of sinistral portal hypertension

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