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Journal of Visceral Surgery Jun 2024Whether congenital or acquired, wandering spleen is a rare entity. In most cases, surgical treatment necessitates splenectomy, or even more rarely, particularly in...
Whether congenital or acquired, wandering spleen is a rare entity. In most cases, surgical treatment necessitates splenectomy, or even more rarely, particularly in children, splenopexy.
PubMed: 38839447
DOI: 10.1016/j.jviscsurg.2024.05.005 -
The New England Journal of Medicine Nov 2020
Topics: Abdominal Pain; Adult; Cholangitis, Sclerosing; Female; Humans; Magnetic Resonance Imaging; Spleen; Tomography, X-Ray Computed; Torsion Abnormality; Wandering Spleen
PubMed: 33207096
DOI: 10.1056/NEJMicm2003627 -
Cirugia Espanola Mar 2018
Topics: Adult; Female; Humans; Magnetic Resonance Imaging; Wandering Spleen
PubMed: 28774572
DOI: 10.1016/j.ciresp.2017.05.011 -
Journal of Gastrointestinal Surgery :... Mar 2018
PubMed: 28875287
DOI: 10.1007/s11605-017-3560-5 -
Current Problems in Diagnostic Radiology 2018An ectopic (or "wandering") spleen results from abnormal ligamentous laxity failing to fixate the spleen in its normal location in the left upper quadrant. Ligamentous... (Review)
Review
An ectopic (or "wandering") spleen results from abnormal ligamentous laxity failing to fixate the spleen in its normal location in the left upper quadrant. Ligamentous laxity can be acquired due to conditions, such as splenomegaly or pregnancy, but is often congenital. Because of this laxity, there is an elongated vascular pedicle, which is prone to torsion and resultant splenic infarction. These patients generally present with abdominal pain and other nonspecific symptoms making the diagnosis very difficult to make clinically. As such, the radiologist plays a crucial role in the diagnosis and care of these patients, as often the diagnosis is only considered after imaging.
Topics: Contrast Media; Diagnosis, Differential; Humans; Tomography, X-Ray Computed; Wandering Spleen
PubMed: 28385371
DOI: 10.1067/j.cpradiol.2017.02.007 -
Abdominal Radiology (New York) Sep 2018
Topics: Diagnosis, Differential; Humans; Torsion Abnormality; Wandering Spleen
PubMed: 29450603
DOI: 10.1007/s00261-018-1488-1 -
Digestive and Liver Disease : Official... Apr 2021
Topics: Abdominal Pain; Acute Pain; Adult; Female; Humans; Splenomegaly; Tomography, X-Ray Computed; Wandering Spleen
PubMed: 32646735
DOI: 10.1016/j.dld.2020.06.025 -
Abdominal Radiology (New York) May 2023The wandering spleen, wandering liver, and wandering kidney are rare diagnoses that can be asymptomatic or are associated with nonspecific symptoms, making the clinical... (Review)
Review
The wandering spleen, wandering liver, and wandering kidney are rare diagnoses that can be asymptomatic or are associated with nonspecific symptoms, making the clinical diagnosis elusive. In addition, given the small number of cases, these conditions are not well understood. Major complications of wandering spleen result from torsion of the vascular pedicle with resultant ischemia, physiologic dysfunction, and/or infarction. Wandering liver is commonly associated with bowel obstruction, particularly colonic volvulus, with very rare reports of hepatic ischemia or infarct. Wandering kidneys are not commonly associated with serious complications. In many cases, the wandering spleen, liver or kidney can be found in their anatomic position on static imaging and are only diagnosed during ultrasound or with serial radiographic or cross-sectional imaging with different patient positioning, or with prior studies demonstrating different locations of the involved organ. Treatment approaches for uncomplicated wandering spleen, liver, or kidney include watchful waiting and splenopexy, hepatopexy, or nephropexy, respectively. Complicated wandering spleens are treated with splenectomy. Given the variable clinical presentation of these conditions, imaging plays a pivotal role in diagnosing these rare and often incidentally discovered phenomena.
Topics: Humans; Wandering Spleen; Torsion Abnormality; Liver; Infarction; Kidney; Radiologists
PubMed: 36752858
DOI: 10.1007/s00261-022-03789-7 -
Emergency Radiology Oct 2020Wandering spleen (or ectopic spleen) is a rare anomaly resulting from hyperlaxity or even absence of the ligaments that hold the spleen in its anatomical position.... (Review)
Review
Wandering spleen (or ectopic spleen) is a rare anomaly resulting from hyperlaxity or even absence of the ligaments that hold the spleen in its anatomical position. Although more frequently a congenital condition, it can also be acquired. Torsion of the vascular pedicle is its potential main complication with subsequent development of splenic infarct. In this paper we will describe the pathogenesis, clinical manifestations, treatment options and radiological findings which allow the diagnosis of this entity.
Topics: Contrast Media; Diagnosis, Differential; Humans; Torsion Abnormality; Wandering Spleen
PubMed: 32424633
DOI: 10.1007/s10140-020-01786-1 -
International Journal of Surgery Case... Aug 2021A wandering spleen is characterized by excessive splenic mobility due to the laxity of its ligaments, which leads to spleen migration and its long mobile vascular...
INTRODUCTION AND IMPORTANCE
A wandering spleen is characterized by excessive splenic mobility due to the laxity of its ligaments, which leads to spleen migration and its long mobile vascular pedicle is liable to torsion. The purpose of this paper was to present a wandering splenomegaly reduction after splenic detorsion and splenopexy.
CASE PRESENTATION
A 14-year-old boy presented a symptomatic visible pelvic wandering splenomegaly with torsion of the splenic pedicle. He was submitted to laparotomy, detorsion of the spleen, and splenopexy to the left diaphragm and surrounded peritoneum. The patient had an uneventful follow-up and was discharged from the hospital on the second postoperative day. All laboratory exams went to normal. The size of the spleen reduced from the 22 × 16 × 13 cm before the treatment to 14 × 12 × 10 cm after the surgical procedure.
CLINICAL DISCUSSION
The most relevant aspect of this communication is the reduction of the huge splenomegaly to a normal size spleen after detorsion of the splenic vessels and splenopexy to the left diaphragm. Reduction of the splenic size is well-known after distal splenorenal shunt, but this is the first publication of a spontaneous splenic size reduction after treating a congestive wandering splenomegaly by detorsion of the spleen pedicle.
CONCLUSION
Ectopic congestive splenomegaly due to the splenic pedicle rotation is adequately treated by splenic detorsion and splenopexy in its proper subdiaphragmatic site, which reduces the splenic size to normal.
PubMed: 34388905
DOI: 10.1016/j.ijscr.2021.106273