The Wandering Spleen in Infancy and Childhood

Abstract

The wandering spleen is an unusual entity, which has been described rarely in infants and children. Although patients may be asymptomatic, some may present with torsion of the spleen with associated vovulus and vascular infarcation. Two asymptomatic patients with wandering spleen are described. Radiographic signs and isotopic scan findings of wandering spleen are discussed and the literature is reviewed.

The wandering spleen

“…Splenomegaly has been suggested as a factor producing increased mobility of the spleen by torsion of the pedicle [1], but mobile spleen are not more common in those parts of the world where diseases producing splenomegaly are very frequent [201. Patients with a wandering spleen may be asymptomatic [18].…”

CT of acute splenic torsion in children with wandering spleen.

“…Although several reports of the sonographic and scintigraphic features of torsion both in children and adults have been published [2][3][4][5][6][7][8][9], little information is available on the CT appearance of torsion, particubarly acute torsion [1 0, 1 1]. We report two cases of acute splenic torsion in children to show the characteristic CT findings of this condition.…”

The technique of laparoscopic retroperitoneal splenopexy for symptomatic wandering spleen in childhood

“…Intermittent abdominal pain is caused by torsion or vascular kinking leading to ischemia or obstruction of venous return, followed by acute enlargement and painful capsular tension [4]. Infarction is rare, but nonoperative treatment of symptomatic wandering spleen has a complication rate up to 65% [5]. We report a new technique of creating a retroperitoneal pouch laparoscopically by a saline-filled balloon via an intercostal trocar, which is suited particularly for infants and children using exclusively autologous material.…”