Splenic Autotransplantation for a Congested and Enlarged Wandering Spleen with Torsion: Report of a Case

Abstract

In children with diseases of the spleen, every effort should be made to preserve the organ, to prevent severe infections postsplenectomy. We report the case of a 7-year-old girl with torsion of a wandering spleen who we treated by autotransplantation of splenic tissues following splenectomy, when fixation of the enlarged spleen seemed impossible. Spleen scintigraphy showed uptake in the regenerating splenic tissues 9 months after surgery, and evidence of an increase in the size of the tissues 23 months after surgery. Howell-Jolly bodies had disappeared by 16 months after surgery. These findings suggested that the transplanted splenic tissues were resuming splenic functions. Based on our experience with this case, we conclude that autotransplantation after splenectomy is a treatment option for wandering spleen with torsion when fixation seems difficult because of splenic congestion and enlargement.

Auto-Transplantation of Splenic Fragments After Total Splenectomy in Patients with Severe Splenic Trauma Lesions: A Clinical Study

“…Sipka et al (17) reported a non-significant increase in the number of lymphocytes at 8 months after total splenectomy and autotransplantation of splenic fragments in mice compared to those that underwent total splenectomy alone. Similar to the current study, it has been reported that phagocytic function of autotransplanted splenic fragments is not regained in the early months after autotransplantation, due to inflammatory response, which improves relatively over time (3,8,22).…”

Abdominal pain and wandering spleen in young children: the importance of an early diagnosis

“…The absence or abnormal laxity of splenic attachments because of either acquired or congenital causes [1,6,7], combined with an abnormally long and mobile vascular pedicle, predisposes the WS to a number of complications with torsion [7].…”

“…Takayasu [6] reported a case of autotransplantation, in which parts of the splenic tissue are transplanted into pouches created in the omentum.…”

Single-Incision Laparoscopic Splenectomy and Splenic Autotransplantation for an Enlarged Wandering Spleen with Torsion

“…Both procedures have been reported when laparotomy was performed, but there have been no reports of these treatments being performed laparoscopically. 9 10 It is very difficult to perform an elective partial splenectomy and fix the residual hemispleen to the diaphragm during laparoscopic procedure. On the other hand, we thought that it would be possible to perform splenectomy and splenic autotransplantation laparoscopically.…”