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Journal of Surgical Case Reports Feb 2020Wandering spleen is a rare condition characterized by the absence or underdevelopment of one or all spleen ligaments that fixate the spleen in the left upper quadrant....
Wandering spleen is a rare condition characterized by the absence or underdevelopment of one or all spleen ligaments that fixate the spleen in the left upper quadrant. Many different terms refer to wandering spleen like dislocated spleen, ectopic spleen and displaced spleen. We report in this case a 13-year-old Syrian girl presented to the emergency department complaining of acute generalized abdominal pain with fever, anorexia and vomiting started 2 days prior to presentation. A splenectomy was performed, with uneventful postsurgical follow-up. Wandering spleen is prone to torsion and infarction resulting in acute abdomen and a life-threatening condition with high mortality rate reaching 50%. We advise the investigation of any recurrent episodes of chronic pain keeping up within mind this diagnosis.
PubMed: 32082535
DOI: 10.1093/jscr/rjz378 -
Annals of Medicine and Surgery (2012) Feb 2020Wandering spleen (WS) is a rare clinical entity resulting from the absence or maldevelopment of the ligaments normally involved in the attachment of the spleen in its...
BACKGROUND
Wandering spleen (WS) is a rare clinical entity resulting from the absence or maldevelopment of the ligaments normally involved in the attachment of the spleen in its normal position. WS can be a cause of acute abdomen leading to different complications ranging from torsion of the vascular pedicle to spleen infarction. Often, in absence of symptoms, it is an occasional finding during radiological exams and surgery represents the gold standard in the management of this unusual condition.
CASE PRESENTATION
We present a case of wandering spleen in a young nulliparous female with an history of recurrent abdominal pain. A preoperative CT-scan of the abdomen showed the presence of a multi-infarcted spleen twisted several times around its vascular pedicle, involving the tail of pancreas. The patient was electively treated with laparoscopic splenectomy.
CONCLUSIONS
A laparoscopic approach is feasible in the treatment of this pathology. A correct and timely diagnosis of this condition is crucial to allow an organ preserving surgery. There are only few reported cases in literature describing an involvement of the tail of the pancreas in the torsion of the vascular pedicle. Complete excision of the ectasic veins tributaries of the splenic vein avoids the risk of postoperative vein thrombosis and bleeding.
PubMed: 32021685
DOI: 10.1016/j.amsu.2019.12.001 -
Case Reports in Surgery 2019Epidermoid splenic cysts are rare lesions in the spleen. These cysts are characterized by a stratified squamous epithelial lining, internal septations, and...
Epidermoid splenic cysts are rare lesions in the spleen. These cysts are characterized by a stratified squamous epithelial lining, internal septations, and calcification. Congenital in origin, epidermoid splenic cysts are postulated to arise from misfolding and mesothelial cell incorporation into the splenic parenchyma. This report presents a unique case of an 18-year-old woman with an epidermoid splenic cyst in a congenital wandering spleen. Computed tomography and transabdominal ultrasound imaging along with immunochemistry staining confirmed the diagnosis. To the authors' knowledge, this is the first reported case of an epidermoid cyst in a wandering spleen.
PubMed: 31827967
DOI: 10.1155/2019/1581736 -
BMJ Case Reports Dec 2019The spleen is an intraperitoneal organ typically located in the left upper quadrant. Ectopic ('wandering') spleen refers to the displacement of the spleen from its...
The spleen is an intraperitoneal organ typically located in the left upper quadrant. Ectopic ('wandering') spleen refers to the displacement of the spleen from its normal anatomical location to another region in the abdominal cavity or pelvis. It's a relatively rare condition with no clear aetiology. We present, here, a case of a wandering spleen following sleeve gastrectomy in a 23-year-old female patient, whose spleen, prior to this event, was demonstrated by imaging in a normal anatomical position. A splenectomy was performed, and after an uneventful postoperative period, the patient was discharged. No similar case description was found in the relevant medical literature. Possible causes and decision-making process are discussed. We conclude that the wandering spleen phenomenon should be considered in the differential diagnosis of patients presenting with abdominal pain and new abdominal mass following sleeve gastrectomy.
Topics: Diagnosis, Differential; Female; Gastrectomy; Humans; Obesity, Morbid; Postoperative Period; Splenectomy; Wandering Spleen; Young Adult
PubMed: 31811094
DOI: 10.1136/bcr-2019-232494 -
The Turkish Journal of Gastroenterology... Sep 2019
Topics: Female; Humans; Tomography, X-Ray Computed; Wandering Spleen; Young Adult
PubMed: 31530528
DOI: 10.5152/tjg.2019.18657 -
BMJ Case Reports Sep 2019Pseudocysts of the spleen are rare, generally asymptomatic lesions developing secondary to trauma, infection or infarction. When symptomatic, they typically present as...
Pseudocysts of the spleen are rare, generally asymptomatic lesions developing secondary to trauma, infection or infarction. When symptomatic, they typically present as non-specific pain in the left hypochondrium, with or without a palpable lump on clinical examination. However, these conventions fail when they occur in a wandering spleen, making imaging critically important. This report describes an unusual case of a 50-year-old who presented with a large cystic mass in a pelvic spleen; imaging facilitated a successful splenectomy and subsequent histopathology revealed a pseudocyst in a wandering spleen.
Topics: Cysts; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Splenectomy; Splenic Diseases; Tomography, X-Ray Computed; Ultrasonography, Doppler, Color; Wandering Spleen
PubMed: 31492728
DOI: 10.1136/bcr-2019-229948 -
Radiology Case Reports Oct 2019Wandering spleen is a rare condition, occurring due to either abnormal development of or abnormal laxity of suspensory ligaments. The hypermobility of the spleen...
Wandering spleen is a rare condition, occurring due to either abnormal development of or abnormal laxity of suspensory ligaments. The hypermobility of the spleen predisposes these patients to splenic torsion, which may be a life-threatening complication. The clinical presentation of wandering spleen varies widely from vague pain to an acute abdomen. There are numerous case reports of other congenital anomalies in children with a wandering spleen. We present a case of wandering spleen with splenic torsion in a child with DiGeorge syndrome, which to our knowledge has not been previously reported.
PubMed: 31440319
DOI: 10.1016/j.radcr.2019.06.018 -
The American Journal of Case Reports Aug 2019BACKGROUND Splenic cysts are rare. Most are due to previous trauma, infection, or infarction. They are generally handled by laparoscopic surgical removal if they are...
BACKGROUND Splenic cysts are rare. Most are due to previous trauma, infection, or infarction. They are generally handled by laparoscopic surgical removal if they are larger than 5 cm. However, very large cysts may require splenectomy. Another factor in the choice of therapy is the patient's underlying condition. We present the case of a giant splenic cyst in a woman 1 year after a renal transplant. CASE REPORT A 28-year-old woman presented with acute abdominal pain and nausea. One year before, she had received an ABO-identical living donor renal transplantation from her father, and was maintained on oral tacrolimus and prednisolone. A CT scan with contrast showed enteric ileus and an abnormal position of the spleen, which was involved by a cyst measuring 12×12.5×9 cm. A nasogastric tube, and later a small bowel tube, were inserted to decompress the ileus. The patient underwent laparotomy 11 days after admission. We confirmed an internal hernia with volvulus due to migration of the spleen; however, there was no evidence of necrosis. The patient was treated with splenectomy and reduction of the hernia. There were no complications. CONCLUSIONS This was a very unusual emergency following renal transplantation. Splenectomy has been performed in the past for immunosuppression in cases of donor ABO-incompatibility. We therefore considered that it would be more expedient to remove the spleen than to remove the cyst and perform splenopexy.
Topics: Abdominal Pain; Adult; Cysts; Female; Humans; Ileus; Intestine, Small; Kidney Transplantation; Splenectomy; Wandering Spleen
PubMed: 31371695
DOI: 10.12659/AJCR.916845 -
Radiology Case Reports Aug 2019The concurrence of wandering spleen, organoaxial gastric volvulus, and pancreatic volvulus is very rare. They have been associated with symptoms such as severe abdominal...
The concurrence of wandering spleen, organoaxial gastric volvulus, and pancreatic volvulus is very rare. They have been associated with symptoms such as severe abdominal pain, abdominal distention, and vomiting. However, the diagnosis remains complicated and any delay can result in ischemia and necrosis of the organs involved. In this case presentation, we present a unique case involving a 14-year-old girl who presented initially with acute abdominal pain. Assessment with enhanced computed tomography scan led to the diagnosis of wandering spleen, organoaxial gastric volvulus, and pancreatic volvulus, in addition to cholestasis, making it the first study to report on the simultaneous occurrence of this triad and cholestasis.
PubMed: 31193859
DOI: 10.1016/j.radcr.2019.05.018