Torsion of wandering spleen

Emergency laparoscopic splenectomy for torsion of wandering spleen in a geriatric patient: A case report

“…The pathophysiology of WS is characterised by the hypermobility of the spleen secondary to the absence or excessive laxity of the following primary splenic suspensory ligaments: gastrosplenic, splenorenal, splenocolic, splenophrenic, pancreaticosplenic, and pre-splenic folds [1,4,[6], [7], [8], [9], [10],13,16]. Due to the abnormality or absence of these ligaments, the splenic vascular pedicle in WS is susceptible to elongation and torsion [1,7,8,12]. The aetiology of WS is considered to be multifactorial and broadly divided into congenital anomalies and acquired conditions [1,6,7].…”

“…Most patients with WS are asymptomatic [10]. Commonly, WS is detected incidentally in physical examination as an abdominal mass or in imaging studies performed for other conditions [3,[6], [7], [8],[12], [13], [14]]. Paediatric WS patients usually present with acute abdominal pain, whereas abdominal mass is the most common complaint in adult WS patients [6].…”

“…Due to the non-pathognomonic history and clinical manifestation, radiological modalities are paramount in attaining a definitive diagnosis [1,3,5,6,[9], [10], [11], [12], [13], [14]]. Imaging studies provide vital information, such as splenic blood flow and viability to aid in management planning [3,7,11].…”

“…Wandering spleen (WS) is a rare congenital or acquired condition where the spleen is not found in the left hypochondrium [[1], [2], [3], [4], [5], [6], [7], [8], [9], [10], [11]]. This abnormality occurs secondary to the absence or laxity of splenic suspensory ligaments [[1], [2], [3], [4], [5], [6], [7], [8], [9], [10], [11], [12], [13]]. The spleen might be displaced within the abdominal or pelvic cavity due to hypermobility [2,[6], [7], [8], [9], [10], [11]].…”

“…Clinical presentations vary from asymptomatic incidental discovery to a life-threatening acute abdomen [1,2,8,10,11]. Imaging modalities can aid in diagnosis and assessment [[1], [2], [3][5], [6], [7], [8], [9], [10][12], [13], [14]]. A WS is managed surgically with a splenopexy or splenectomy, using a laparotomy or laparoscopic approach [[1], [2], [3], [4],[6], [7], [8], [9], [10], [11], [12], [13], [14]].…”