Torsion of the wandering spleen: Splenectomy or splenopexy

The wandering spleen

“…A recent study [16] advocates splenopexy in all cases of wandering spleen; splenectomy should be reserved for patients with splenic torsion in whome thrombosis of the splenic vessels resulting in massive infarction has already occurred. If the spleen is too large to perform a splenopexy, a subtotal splenectomy could be done.…”

Wandering spleen: as a differential diagnosis in pelvic masses

“…3 However, acquired anomalies have been described and are mainly attributed to laxity of the ligaments due to weakness of the abdominal wall, multiple pregnancies, hormonal changes or increase in size of the spleen. 4 Both congenital and acquired conditions result in a long pedicle, which is predisposed to torsion. The splenic vessels course within the pedicle, and therefore, torsion of the pedicle results in partial or complete infarct of the spleen.…”

“…Torsion is the most common complication. 4 It usually presents as an acute abdominal problem. This makes the physical examination more difficult and preoperative diagnosis less accurate.…”

“…11,12 Stringel et al fixed the spleen via its pedicle. 4 [16][17][18][19] Actually, laparoscopic splenopexy is an easy alternative to laparotomy. The laparoscopic approaches reported have used sacks and slings of Dexon® or Vicryl® mesh for fixation or an autologous peritoneal pouch in the posterolateral abdominal wall permitting to avoid the risk of infection of the mesh.…”

Torsion of Wandering Spleen: Case Report and Literature Review

“…The acquired anomaly has been attributed to weakness of the abdominal wall, multiple pregnancies, hormonal changes or increase in size of the spleen with a long pedicle. [6][7][8] Congenital wandering spleen is thought to be due to abnormal development of the dorsal mesogastrium, 8 as the spleen arises as a condensation of mesoderm in the dorsal mesogastrium. The most commonly described clinical picture is the presence of a palpable mass associated with abdominal discomfort.…”