Torsion of Wandering Spleen: A Case Report

Göksu, Mustafa; Baykan, Ali Haydar

doi:10.1016/j.jemermed.2020.01.012

Cited by 10 publications

(9 citation statements)

References 7 publications

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“…Wandering spleen is a spleen with hypermobility which can migrate to any area of the abdomen or pelvis [11]. It's generally considered a congenital abnormality in children and rarely encountered [5,12,13]. The normal spleen is located at left hypochondrium and fixed to the retroperitoneum by some main splenic suspensory ligaments, namely gastrosplenic, splenorenal, splenocolic, and splenophrenic ligaments [14,15].…”

Section: Discussionmentioning

confidence: 99%

Diagnosis and treatment of splenic torsion in children: preoperative thrombocytosis predicts splenic infarction

Wang

Peng

et al. 2022

BMC Pediatr

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Background Pediatric splenic torsion is a rare entity, and the most common cause is wandering spleen. This study aimed to summarize our clinical experience in the diagnosis and surgical treatment pediatric patients with splenic torsion, and to use preoperative thrombocytosis as a preoperative predictive factor for splenic infarction. Methods From January 1st, 2016 to December 31st, 2021, 6 children diagnosed as splenic torsion were included. All patients were surgically treated and followed up. The clinical data was collected including clinical presentations, laboratory tests, imaging results, surgical procedures, and prognosis. Clinical experience of diagnosis and surgical treatment were summarized. Results There were 4 females and 2 males, with median age at surgery 102.6 (range 9.4–170.7) months. Abdominal pain and abdominal mass were the most common presentations. The diagnosis of splenic torsion depended on imaging studies, and adjacent organ involvement (gastric and pancreas torsion) was observed on contrast CT in one patient. Five patients were diagnosed as torsion of wandering spleen, and one was torsion of wandering accessory spleen. Emergent laparoscopic or open splenectomy was performed in all patients. Pathology revealed total splenic infarction in 4 patients, partial infarction in 1 patient, and viable spleen with congestion and hemorrhage in 1 patient. Preoperative platelet counts were elevated in all 4 patients with splenic infarction, but normal in the rest 2 with viable spleen. Postoperative transient portal vein branch thromboembolism occurred in one patient. Conclusions Imaging modalities are crucial for the diagnosis of pediatric splenic torsion and adjacent organ involvement. Preoperative thrombocytosis may predict splenic infarction. Spleen preserving surgery should be seriously considered over splenectomy in patients with a viable spleen.

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Section: Discussionmentioning

confidence: 99%

Diagnosis and treatment of splenic torsion in children: preoperative thrombocytosis predicts splenic infarction

Wang

Peng

et al. 2022

BMC Pediatr

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“…Although WS is most common in the neonatal period (primarily in men), it is seen ten times more in women than men after the age of ten [ 3 ]. While adults usually present with symptoms of an abdominal mass, children generally present with abdominal pain [ 4 ].…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic Splenopexy Due to Wandering Spleen: Feasible Technique

Sümer¹,

Okut²,

Kaplan³

et al. 2022

Cureus

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Wandering spleen (WS) is a rare disease caused by the looseness of the splenic ligaments. A 29-year-old female patient presented to the emergency department with complaints of abdominal pain and a palpable mass in the abdomen. A diagnosis of WS was made as a result of preoperative imaging. We performed urgent laparoscopic splenopexy with non-absorbable mesh in a patient with torsioned WS. WS is a disease that must be operated on urgently because it causes ischemia and necrosis in cases where it causes torsion in the splenic pedicle. Many researchers also recommend surgery in asymptomatic patients. While splenectomy was previously recommended for WS, current recommendations advocate for splenopexy. As a result, the only and definite treatment option in the case of WS is surgery. Splenopexy with minimally invasive techniques should be the first choice if possible. Splenopexy with non-absorbable mesh is an inexpensive and feasible method to prevent re-torsion. The use of non-absorbable mesh in laparoscopic splenopexy has not been shared before in the literature.

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“…The definitive treatment of wandering spleen is surgical. Splenopexy is preferred for uncomplicated cases 4 . Splenectomy is performed in cases complicated by torsion with infarction or ischaemia 5 .…”

Section: Figmentioning

confidence: 99%