Wandering spleen with torsion and infarction: A case report

Lugo-Fagundo, Elias; Fishman, Elliot K.

doi:10.1016/j.radcr.2022.06.073

Cited by 4 publications

(1 citation statement)

References 7 publications

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“…20 Potential complications of wandering spleen includes sepsis, splenic rupture, and acute pancreatitis. 21 Patients with splenic torsion may appear with an acute abdomen from an infarction. Reports showed that Spleen weight larger than 500gm and prolonged twisting greater than 180° predispose to splenic infarction.…”

Section: Discussionmentioning

confidence: 99%

Wandering Spleen with Splenic Torsion: Unusual Cause of Acute Abdomen

Ahmed¹,

Mahmood²,

Negash³

et al. 2022

IMCRJ

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Wandering spleen is a rare condition characterised by laxity or lack of splenic ligaments as a result of acquired or congenital causes. There is a possibility of misdiagnosis due to its vague symptoms. In order to make a proper diagnosis, imaging techniques including abdominal ultrasonography and CT scanning are essential. Surgery is the main option of management. If the spleen is viable and there is no thrombosis in the splenic veins, splenopexy is the preferred surgical procedure. Alternatively, splenectomy plus prophylactic antibiotic and vaccination usage may be employed if spleen has infarction. Case Presentation: A 12-year-old male child who had previously experienced constipation, mucoid diarrhoea, and abdominal distention arrived with crampy abdominal pain that had lasted for four days. The patient was tachycardic with abdominal tenderness. Whirlpool sign and lack of a spleen in its normal position were visualized on an abdominal ultrasound. The spleen was located intraoperatively in the lower abdomen, adhered to the ileum and appendix. It was 720° twisted and had necrotic areas. The patient underwent an appendectomy with splenectomy with a smooth post-operative course; combination meningococcal and pneumococcal vaccines were administered; and antibiotic prophylaxis was started for the patient. Conclusion: High clinical suspicion and the use of imaging modalities like ultrasound and CT scan are extremely crucial to diagnose wandering spleen and perform splenic salvage surgery because its clinical diagnosis is challenging.

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Section: Discussionmentioning

confidence: 99%