Laparoscopic splenopexy and cystectomy for an enlarged wandering spleen and splenic cyst

Upadhyaya, P.; Peter, Shawn D. St.; Holcomb, George

doi:10.1016/j.jpedsurg.2007.03.001

Cited by 14 publications

(13 citation statements)

References 25 publications

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“…Wandering spleen in children is a condition that is rarely displayed in the professional literature, (1,2) where it is most often talked about its congenital origin (4,13,20). Given the early onset of symptoms, as is the case in our patient, asymptomatic flow with occasional abdominal symptomatology can be attributed to occasional torsion/detachment of ligaments and/or vascular spleen or spontaneous gastrointestinal obstruction (19,21,22). An echosonographic examination revealed the ectopic position of the spleen only after its permanent fixation in the new position (12,23).…”

Section: Discussionmentioning

confidence: 69%

Wandering Spleen - A Possible Cause of Adrenal “Mass” - Case Report

Markovic

Paunović

Vuletic

et al. 2021

Serbian Journal of Experimental and Clinical Research

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Wandering spleen is a very rare clinical condition characterized by spleen absence in the normal anatomical location in the upper left quadrant of the abdomen and its presence at another location in the abdomen or pelvis. The ectopic spleen is extremely rare in children, where its increased mobility is the result of a congenital disturbance of the fixation for the anterior wall due to the absence or weakness of the supporting ligaments. Wandering spleen is usually asymptomatic, but its torsion is possible, as well as infarction or rupture which demand an urgent diagnosis and surgical treatment. The diagnosis of wandering spleen can easily be overlooked due to low incidence and insufficient clinical experience, which multiplies patient’s risk from life-threatening conditions. We present a case of wandering spleen in an 11-year-old girl with acute abdominal pain, which after ultrasound examination raised suspicion on the right adrenal gland tumor. Additional diagnostics verified an ectopic spleen in the right adrenal box, after which the recommended preventive splenopexy was seriously considered. Due to the fixation of the vital spleen in the new position, but also the negative attitude of the parents towards the surgical intervention, clinical monitoring was selected, with exclusion of intense physical activity that carries the risk of traumatization of the spleen. As the girl has been in good health for over 3 years and without symptoms, we consider that the selection of conservative access although difficult, was correct. We hope that our experience in treating wandering spleen in girls will increase the number of valid facts about this rare condition.

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Section: Discussionmentioning

confidence: 69%

Wandering Spleen - A Possible Cause of Adrenal “Mass” - Case Report

Markovic

Paunović

Vuletic

et al. 2021

Serbian Journal of Experimental and Clinical Research

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“…Torri et al [7] used 5 mm absorbable spirals as employed in adult hernia repair instead of conventional stitch placement making fixation extremely quick and safe. Upadhyaya et al [1] used traction and countertraction and blunt dissection to create an extraperitoneal pouch and then pulled up the peritoneal flaps to keep the spleen in place. Extraperitoneal fixation was also favoured either by simple dissection, or by inserting a special balloon device or a glove finger and filling it with saline, and thus, mechanically creating a pouch to house the spleen.…”

Section: Discussionmentioning

confidence: 99%

“…The incidence of wandering spleen has not been precisely determined. It has been reported in multiparous females of the childbearing age group[1] and only in a few cases in the paediatric population. The pathophysiology of wandering spleen consists of a failure in the development of the primary ligamentous attachment of the spleen or a laxity of these ligaments due to an underdeveloped dorsal mesentery.…”

Section: Introductionmentioning

confidence: 99%

Is laparoscopic approach for wandering spleen in children an option?

Alqadi

Saxena

2019

J Min Access Surg

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“…Within the patients who underwent splenopexy, three patients underwent splenopexy and gastropexy for gastric volvulus (two were performed by laparotomy and one by laparoscopy) [15-17]. Splenic cysts were noted in two cases thus requiring splenopexy and cystectomy, both performed as open procedures [18,19]. For patients that had viable spleens intraoperatively and underwent splenopexy, six had mesh placed to secure the spleen (four used vicryl mesh, one reported use of non-absorbable mesh, and one had polypropylene) [14,19-22].…”

Section: Discussionmentioning

confidence: 99%

Non-operative management of a rare diagnosis of splenic torsion in a child with a history of giant omphalocele: a case report and literature review

et al. 2014

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BackgroundSplenic torsion is rare and as a result the appropriate management is unclear. While there has been a shift towards splenectomy and laparoscopic splenopexy, we present a successful case of non-operative management of splenic torsion in a patient with a history of a giant omphalocele.Case presentationA 3 year-old female presented with a three-day history of abdominal pain, fever and non-bloody emesis three and a half years after repair of her giant omphalocele. Abdominal radiographs and ultrasound demonstrated migration of the spleen and a subsequent computerized tomography scan confirmed splenic torsion and an infarcted spleen. Given her late presentation, she was successfully managed with observation, analgesia, immunization against capsulated organisms and daily penicillin prophylaxis with excellent outcome at 19 months follow-up. A review of the literature revealed that splenic torsion is rarely managed non-operatively. Rarer still is the occurrence of splenic torsion following a history of omphalocele.ConclusionAlthough rare, splenic torsion should be considered in a child with a history of omphalocele presenting with abdominal pain. Non-operative management of an infarcted spleen can be a safe treatment option to avoid surgery in complex patients.

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Laparoscopic splenopexy and cystectomy for an enlarged wandering spleen and splenic cyst

Cited by 14 publications

References 25 publications

Wandering Spleen - A Possible Cause of Adrenal “Mass” - Case Report

Wandering Spleen - A Possible Cause of Adrenal “Mass” - Case Report

Is laparoscopic approach for wandering spleen in children an option?

Non-operative management of a rare diagnosis of splenic torsion in a child with a history of giant omphalocele: a case report and literature review

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