Torsion of a wandering spleen a case report
##plugins.themes.academic_pro.article.main##
Abstract
Background: Wandering spleen is a rare entity in child. It is generated by laxity or failure of development of spleen ligaments causing the migration of the spleen from its normal anatomical site to another abdominal or pelvic location. It can be congenital or acquired. The most dangerous complication is the occurrence of torsion of the spleen around its pedicle.
aim: Report of a new observation and present the diagnostic, treatment and outcome aspects of torsion of ectopic spleen.
Case: We report the case of a 17 years old girl who was admitted for an acute abdomen pain and fever. Clinical examination revealed generalized abdominal defence and an under umbilical mass which was very painful on palpation. Ultrasound and CT scans have visualized the pelvic mass, which measured four inches long axis.
The spleen wasn’t on its normal seat. The patient was operated urgently. Surgical exploration showed that the mass corresponded to a wandering spleen in pelvic position, necrotic and twisted around its pedicle. A splenectomy was performed with simple sequences.
Conclusion: torsion of the wandering spleen can progress to total necrosis of the spleen mass. This complication is feared in any ectopic and painful spleen.
aim: Report of a new observation and present the diagnostic, treatment and outcome aspects of torsion of ectopic spleen.
Case: We report the case of a 17 years old girl who was admitted for an acute abdomen pain and fever. Clinical examination revealed generalized abdominal defence and an under umbilical mass which was very painful on palpation. Ultrasound and CT scans have visualized the pelvic mass, which measured four inches long axis.
The spleen wasn’t on its normal seat. The patient was operated urgently. Surgical exploration showed that the mass corresponded to a wandering spleen in pelvic position, necrotic and twisted around its pedicle. A splenectomy was performed with simple sequences.
Conclusion: torsion of the wandering spleen can progress to total necrosis of the spleen mass. This complication is feared in any ectopic and painful spleen.
Keywords:
Spleen, wandering spleen, Splenectomy, Splenopexy##plugins.themes.academic_pro.article.details##
References
- Gayer G, Zissin R, Apter S, Atar E, Portnoy O, Itzchak Y. Pictorial review CT findings in congenital anomalies of the spleen. Br J Radiol 2001;74:767-72.
- Freeman JL, Zafar S, Jafri H, Roberts JL, Mezwa DG, Shirkhoda. CT of congenital and acquired abnormalities of the spleen. Radiographics 1993;13:597-610.
- Valls C, Mones L, Guma A, Lopez-Calonge E. Torsion of a wandering accessory spleen: CT findings. Abdom Imaging 1998;23:194-5.
- Horwitz JR, Black CT. Traumatic rupture of a wandering spleen in a child : case report and literature review. J Trauma 1996;41:348-50.
- Buehner M, Baker MS. The Wandering spleen. Surg Gynecol Obstet 1992;175:373-87.
- McFee RB, Musacchio T, Gorgescu D, Bozorgnia M, Abdelsayed G, Pachter BR. Wandering spleen with torsion in a geriatric patient. Report of an unusual case with a brief review of the clinical picture and management. Dig Dis Sci 1995;40:2656-9.
- D.A.K. Woodward , Torsion of the spleen. Am J Surg 1967;114: 953-955.
- Lee T.G., Brickmann F.E., Satter White G.R., Avecilla L.S. Ultrasound demonstration of wandering spleen. Arch. Surg. 1979;114 : 13-15,.
- Setiawan H., Rebeccas S., Harrell, Perret R.S. Ectopic spleen. A sonographic diagnosis. Pediatr. Radiol., 12 : 152-153, 1982.
- J.J. Smulewicz, A.R. Clemett , Torsion of the wandering spleen. Dig Dis 1975 ; 3 : 74-279.
- T. Sugushita, N. Ogawa , S. Asaki , Un cas de rate baladeuse avec varices gastriques. In: RinsyoGeka 1987; 42 : 665-668.
- J.C. Collins , R.C. Cheek , Chronic torsion of the spleen. Am J Surg 1976; 42: 427-429.