Wandering spleen in children: a report of 3 cases and a brief literature review underlining the importance of diagnostic imaging

Lombardi, Roberta; Menchini, Laura; Corneli, Teresa; Magistrelli, Andrea; Accinni, Antonella; Monti, Lidia; Tomà, Paolo

doi:10.1007/s00247-013-2851-6

Cited by 34 publications

(31 citation statements)

References 50 publications

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“…Among these imaging modalities, ultrasonographic evaluation is an inexpensive and noninvasive method used to characterize a WS with ischemia in an emergency room setting [7]. Additional contrast-enhanced CT would further complement the diagnosis by demonstrating signs indicating splenic pedicle torsion [8]. In this study, CT images of the patient showed an intraparenchymal hypodense area with poor contrast enhancement, leaving a residual rim of enhancing capsule supplied by small capsular vessels (rim sign), which is suggestive of parenchymal infarction [9].…”

Section: Discussionmentioning

confidence: 99%

Unusual association of Axenfeld-Rieger syndrome and wandering spleen: a case report

Lin

Chang

et al. 2020

Preprint

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Background : Axenfeld–Rieger syndrome (ARS) is an autosomal dominant genetic disease characterized by ocular developmental disorders and it’s association with torsion of wandering spleen (WS) has not been reported to date to the best of our knowledge. This study aimed to describe a rare case of ARS observed at our emergency department. Case Presentation : A 25-year-old female presented with a constant lower abdominal pain of increasing severity. Diagnostic computed tomography with intravenous contrast material showed a nonhomogenously enhanced splenic parenchyma with a twisted vascular pedicle. Further, an emergent laparoscopic exploration was performed, and an ischemic spleen without its normal ligamentous attachments was noted. Notably, the spleen did not regain its normal vascularity after detorsion; thus, we performed the laparoscopic splenectomy. The postoperative course was uneventful, and the patient was discharged on the 5 th postoperative day. This case demonstrates a rare association of WS and ARS. Conclusion : Early diagnosis of WS in the emergency department is important to prevent pedicle torsion or splenic necrosis and to avoid splenectomy.

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Section: Discussionmentioning

confidence: 99%

Unusual association of Axenfeld-Rieger syndrome and wandering spleen: a case report

Lin

Chang

et al. 2020

Preprint

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“…Abdominal Doppler ultrasonography is the first step in the diagnosis of wandering spleen and can be able to demonstrate the abnormal position of the spleen and to detect the presence of pedicle torsion (“whirl” sign). Though, abdominal CT scan might be necessary in some cases, allowing a better anatomical knowledge of the spleen, its vascularity, the presence and the extent of ischemic lesions, and its relationship with the surrounding organs, such as gastric displacement or volvulus [ 4 , 5 , 14 , 15 ].…”

Section: Discussionmentioning

confidence: 99%

Wandering Spleen and Organoaxial Gastric Volvulus after Morgagni Hernia Repair: A Case Report and Review of the Literature

Cantone

Gulìa

Miele

et al. 2016

Case Reports in Surgery

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Wandering spleen and gastric volvulus are two rare entities that have been described in association with congenital diaphragmatic hernia. The diagnosis is difficult and any delay can result in ischemia and necrosis of both organs. We present a case of a 13-year-old girl, previously operated on for anterior diaphragmatic hernia and intrathoracic gastric volvulus, that presented to our service for a subdiaphragmatic gastric volvulus recurrence associated with a wandering spleen. In this report we reviewed the literature, analyzing the clinical presentation, diagnostic assessment, and treatment options of both conditions, in particular in the case associated with diaphragmatic hernia.

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“…WS is a rare pathological condition characterized by splenic hypermobility due to laxity or absence of its suspensory ligaments. Fewer than 500 cases have been reported in the literature, although the actual incidence is probably unknown because of several asymptomatic unrecognized cases . Associated torsion of the distal pancreas is even rarer, with only four cases having been previously reported (Table ).…”

Section: Discussionmentioning

confidence: 99%

“…Wandering spleen (WS) is an abnormal condition in which the spleen migrates from its anatomical location to any other place in the abdomen. This condition occurs when there is a failure in the development of the primary ligamentous attachment of the spleen or a laxity of these ligaments . In this situation the spleen becomes an entirely intraperitoneal mobile organ, and the distal pancreas is not completely retroperitoneal, leaving its distal portion in the intraperitoneal splenic hilum .…”

Section: Introductionmentioning

confidence: 99%

Urgent laparoscopic mesh splenopexy for torsion of wandering spleen and distal pancreas: A case report

Torri

Parolini

Vanzetti

et al. 2015

Asian J Endoscop Surgery

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Wandering spleen is a condition in which an incomplete fusion of the splenic ligaments allows the spleen to move within the abdomen, predisposing it to splenic torsion along its vascular pedicle. Torsion of a wandering spleen is an uncommon occurrence, especially in children, and associated torsion of the distal pancreas is even more unusual, with only four cases having been reported in adults. Non-specific clinical presentation makes radiologic evaluation essential in order to obtain a diagnosis and to send the patient for early surgery before life-threatening complications arise. Here we present a rare case of torsion of wandering spleen together with volvulus of the distal pancreas in a 13-year-old girl. In this case, prompt radiological assessment allowed for an early diagnosis, and the patient was successfully treated with urgent laparoscopic derotation of both the spleen and the distal pancreas as well as mesh splenopexy. To the best of our knowledge, this procedure has never been described in a pediatric setting.

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Wandering spleen in children: a report of 3 cases and a brief literature review underlining the importance of diagnostic imaging

Abstract: Radiologic evaluation has a major role in confirming the diagnosis of a suspected wandering spleen and avoiding potentially life-threatening complications requiring immediate surgery.

Cited by 34 publications

References 50 publications

Unusual association of Axenfeld-Rieger syndrome and wandering spleen: a case report

Unusual association of Axenfeld-Rieger syndrome and wandering spleen: a case report

Wandering Spleen and Organoaxial Gastric Volvulus after Morgagni Hernia Repair: A Case Report and Review of the Literature

Urgent laparoscopic mesh splenopexy for torsion of wandering spleen and distal pancreas: A case report

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