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BMJ Case Reports Jun 2021Gastric volvulus (GV) and wandering spleen (WS) associated with eventration of diaphragm share a common pathological cause of absence or laxity of intraperitoneal...
Gastric volvulus (GV) and wandering spleen (WS) associated with eventration of diaphragm share a common pathological cause of absence or laxity of intraperitoneal ligaments. We herein report a rare case of a 13-year-old child presenting with an acute GV, WS, diaphragmatic eventration and an ectopic ascended kidney managed with a laparoscopic approach.
Topics: Adolescent; Child; Diaphragmatic Eventration; Humans; Laparoscopy; Ligaments; Stomach Volvulus; Wandering Spleen
PubMed: 34162614
DOI: 10.1136/bcr-2021-242441 -
BMC Surgery Jun 2021Wandering spleen is a rare clinical entity with a less than 0.2% reporting incidence rate. In this case, the spleen is present abnormally in the abdominal or pelvic...
BACKGROUND
Wandering spleen is a rare clinical entity with a less than 0.2% reporting incidence rate. In this case, the spleen is present abnormally in the abdominal or pelvic cavity instead of its normal anatomical location. The aetiology is either congenital or acquired. The condition is caused by the absence or maldevelopment of the spleen's suspensory ligaments, which holds the spleen static in the left hypochondrium.
CASE PRESENTATION
A 27-year-old female patient presented to the emergency department with complaints of abdominal pain, fever, nausea, vomiting, and constipation for three days. A palpable movable mass was found during the physical examination, and torsion of the wandering spleen's pedicle was confirmed by CT scan. Open splenectomy was performed, and the patient was recovered uneventfully.
CONCLUSION
Even though ectopic spleen is a rare disease, clinicians should be aware of its incidence. Early diagnosis in the case of an acute abdomen is vital for the preservation of the spleen. Patients presented with acute abdomen and absence of splenic shadow under left hemidiaphragm should be suspected, and further radiological investigation will confirm the diagnosis. Surgery is the gold standard for wandering spleen with either splenopexy or splenectomy, depending on the spleen's condition during surgery.
Topics: Abdomen, Acute; Adult; Emergency Service, Hospital; Female; Humans; Splenectomy; Torsion Abnormality; Wandering Spleen
PubMed: 34107944
DOI: 10.1186/s12893-021-01289-x -
BMJ Case Reports Apr 2021Gastroschisis is an uncommon congenital defect of the abdominal wall resulting in intestinal prolapse, most commonly associated with short gut syndrome or bowel...
Gastroschisis is an uncommon congenital defect of the abdominal wall resulting in intestinal prolapse, most commonly associated with short gut syndrome or bowel obstruction. Wandering spleen, movement of the spleen due to the underdevelopment of splenic ligaments, has a prevalence of 0.25% and is asymptomatic in 15% of paediatric cases. An 11-year-old patient, admitted with a history of gastroschisis repaired at birth, presents with 18 months of intermittent, worsening abdominal pain. Imaging demonstrated splenomegaly and tortuosity of the splenic vein with abnormal positioning of the superior mesenteric artery and vein. The patient was found to have a wandering spleen with subacute splenic infarct secondary to splenic torsion, necessitating emergent surgical intervention. This patient experienced an extremely rare complication of gastroschisis that has not previously been reported. This complication is caused by a lack of appropriate abdominal fixation points for the spleen.
Topics: Child; Gastroschisis; Humans; Splenectomy; Splenic Diseases; Splenic Infarction; Torsion Abnormality; Wandering Spleen
PubMed: 33883109
DOI: 10.1136/bcr-2020-239520 -
Annals of the Royal College of Surgeons... Apr 2021A wandering spleen is a very rare event characterised by the absence of the spleen in its anatomical position due to the hyperlaxity of its ligaments. We present a case...
A wandering spleen is a very rare event characterised by the absence of the spleen in its anatomical position due to the hyperlaxity of its ligaments. We present a case of wandering spleen complicated by splenic vascular pedicle torsion, thrombosis and subsequent splenic infarction. Compression of the infarcted spleen on the rectosigmoid junction led to the development of a sigmoid volvulus, which presented as an acute large bowel obstruction. The patient underwent emergency laparotomy, splenectomy, sigmoid decompression and sigmoidopexy. After a follow-up period of two years, the volvulus had not recurred.
Topics: Acute Disease; Female; Humans; Intestinal Obstruction; Intestinal Volvulus; Middle Aged; Sigmoid Diseases; Splenectomy; Splenic Infarction; Wandering Spleen
PubMed: 33682463
DOI: 10.1308/rcsann.2020.7144 -
BMJ Case Reports Feb 2021Wandering spleen (WS) is a hypermobile spleen that, due to the laxity of its ligaments, is prone to torsion. We report a case of a 45-year-old multiparous woman who...
Wandering spleen (WS) is a hypermobile spleen that, due to the laxity of its ligaments, is prone to torsion. We report a case of a 45-year-old multiparous woman who presented with acute abdominal pain and a tender palpable mass. A contrast-enhanced computed tomography scan of the abdomen showed a WS with torsion. She underwent an emergency splenectomy and was discharged after an uneventful recovery. She was readmitted with splanchnic venous thrombosis and was managed with therapeutic low-molecular-weight heparin (LMWH) and discharged. Twenty days later, she presented with new-onset abdominal pain. She had not complied with LMWH as advised. The thrombosis had progressed, leading to small bowel gangrene, requiring resection and a stoma. Due to frequent metabolic disturbances, an early reversal of stoma was performed. She was lost to follow-up thereafter. This case highlights a rare indication for emergency splenectomy and one of its major postoperative complications.
Topics: Abdominal Pain; Colectomy; Female; Gangrene; Heparin; Humans; Middle Aged; Postoperative Complications; Splenic Vein; Surgical Stomas; Tomography, X-Ray Computed; Torsion Abnormality; Venous Thrombosis; Wandering Spleen
PubMed: 33541983
DOI: 10.1136/bcr-2020-238647 -
BMJ Case Reports Jan 2021This case highlights a 37-year-old woman with primary sclerosing cholangitis awaiting liver transplantation who presented with torsion of a wandering spleen with...
This case highlights a 37-year-old woman with primary sclerosing cholangitis awaiting liver transplantation who presented with torsion of a wandering spleen with associated gastric and pancreatic volvulus. The patient underwent emergent exploratory laparotomy with splenectomy. She had an uncomplicated postoperative course and recovered well.
Topics: Adult; Cholangitis, Sclerosing; Colectomy; Colitis, Ulcerative; Colonic Pouches; End Stage Liver Disease; Female; Humans; Pancreatic Diseases; Portasystemic Shunt, Transjugular Intrahepatic; Severity of Illness Index; Splenectomy; Splenic Diseases; Splenic Vein; Stomach Volvulus; Thrombosis; Tomography, X-Ray Computed; Torsion Abnormality; Wandering Spleen
PubMed: 33509856
DOI: 10.1136/bcr-2020-235918 -
Ulusal Travma Ve Acil Cerrahi Dergisi =... Jan 2021Wandering spleen is defined as the spleen that is not in its normal anatomic position due to the absence or laxity of suspensory ligaments. Congenital and acquired...
Wandering spleen is defined as the spleen that is not in its normal anatomic position due to the absence or laxity of suspensory ligaments. Congenital and acquired factors play a role in its etiology. It is a rare condition and may cause life-threatening complications as torsion or infarction. Rarely, patients may present to the emergency department with an acute abdomen. They may also present with chronic abdominal pain or intraabdominal mass. Given that its clinical diagnosis is difficult to make, radiological studies have an important role for an accurate diagnosis. In this paper, we presented a 24-year-old patient with torsion of a wandering spleen who presented with an acute abdomen and underwent laparoscopic splenectomy under urgent conditions.
Topics: Abdomen, Acute; Adult; Humans; Laparoscopy; Spleen; Splenectomy; Torsion Abnormality; Wandering Spleen; Young Adult
PubMed: 33394461
DOI: 10.14744/tjtes.2020.00734 -
International Journal of Surgery Case... Jan 2021Anatomical variation of the spleen's position in the abdomen, is a rare condition called Wandering Spleen (WS). WS is a vital differential diagnosis in patients...
INTRODUCTION AND IMPORTANCE
Anatomical variation of the spleen's position in the abdomen, is a rare condition called Wandering Spleen (WS). WS is a vital differential diagnosis in patients presenting with acute abdomen and diagnosis should be made promptly to prevent development of serious complications.
CASE PRESENTATION
In this article, we report two cases of WS (27 and 20 years old females) presenting with abdominal pain due to splenic torsion. Both Patients underwent splenectomy and discharged with no further complications.
CLINICAL DISCUSSION
The presentation of a wandering spleen varies from an asymptomatic mass to an acute abdomen due to torsion and splenic infarction, therefore recognition of this condition can be challenging. Diagnosis depends on imaging studies, and treatment options consist of performing either splenectomy or splenopexy.
CONCLUSION
Concerning the high incidence of splenic torsion and infarction in WS patients, early recognition of this condition and initiation of apt intervention is of great significance.
PubMed: 33373922
DOI: 10.1016/j.ijscr.2020.12.039 -
Journal of Indian Association of... 2020Wandering spleen is a rare pathology. A 2-year-old child with abdominal pain was diagnosed to have a torted, avascular wandering spleen. On conservative management, she...
Wandering spleen is a rare pathology. A 2-year-old child with abdominal pain was diagnosed to have a torted, avascular wandering spleen. On conservative management, she remains well with no radiological evidence of the spleen. Splenic torsion usually warrants surgery. Nonoperative management in selected cases allows the natural process of autosplenectomy.
PubMed: 33343117
DOI: 10.4103/jiaps.JIAPS_216_19 -
The Indian Journal of Radiology &... 2020Wandering spleen refers to a spleen that is ectopic in its location contrary to a normal spleen which rests in the left hypochondrium. Although it is a rare clinical...
Wandering spleen refers to a spleen that is ectopic in its location contrary to a normal spleen which rests in the left hypochondrium. Although it is a rare clinical entity seen in children, it can also be rarely seen in females of reproductive age group. We present one such case of wandering spleen which was misdiagnosed earlier as a sub-hepatic collection.
PubMed: 33273777
DOI: 10.4103/ijri.IJRI_46_20