-
Clinical Case Reports Nov 2022We present a case of a 21-year-old female patient who had a wandering spleen with a large cyst. The celiotomy was performed under the impression of torsion of the...
We present a case of a 21-year-old female patient who had a wandering spleen with a large cyst. The celiotomy was performed under the impression of torsion of the wandering spleen and leakage from the splenic cyst. The total splenectomy was performed instead of cystectomy and splenopexy.
PubMed: 36381033
DOI: 10.1002/ccr3.6559 -
Journal of Surgical Case Reports Oct 2022A 10-year-old girl with a wandering spleen with an enlarged cyst was successfully treated by laparoscopic-assisted partial splenectomy and splenopexy. The patient...
A 10-year-old girl with a wandering spleen with an enlarged cyst was successfully treated by laparoscopic-assisted partial splenectomy and splenopexy. The patient visited our hospital with a complaint of a lower abdominal mass. Abdominal computed tomography showed malposition of the spleen and the presence of a 10 cm diameter splenic cyst (SC) in the lower pole. In surgery, the navel was opened with an inverted Y-shaped incision. The SC was punctured and aspirated the contents of the cyst, the migrating spleen was pulled out of navel and the partial splenectomy was done. The residual spleen was laparoscopically fixed by creating an extraperitoneal pocket. Pathologically, the cyst was covered with a vitrified fibrotic capsule and was diagnosed as a pseudocyst. We considered it a traumatic cyst. The postoperative course was uneventful. This minimally invasive laparoscopic procedure was feasible and effective for treating wandering spleen with a large SC in a pediatric patient.
PubMed: 36285167
DOI: 10.1093/jscr/rjac483 -
International Journal of Surgery Case... Oct 2022• The absence or malformations of splenic suspensory ligaments attaching the spleen to the diaphragm, colon, and retroperitoneum is the major cause of wandering spleen...
• The absence or malformations of splenic suspensory ligaments attaching the spleen to the diaphragm, colon, and retroperitoneum is the major cause of wandering spleen (WS). • Diagnosis is often an occasional finding during radiological exams. • Conservative treatment may lead to high complications. Thus, surgery with organopexy is the standard gold treatment. However, the preserving treatment is debatable in WS associated with idiopathic thrombocytopenic purpura.
PubMed: 36261950
DOI: 10.1016/j.ijscr.2022.107719 -
The American Journal of Case Reports Oct 2022BACKGROUND Wandering spleen (WS) is a rare medical condition in which the spleen migrates from its usual position commonly to the pelvis or lower abdomen assuming an...
Laparoscopic Splenectomy of a Wandering Pelvic Splenomegaly in a Young Woman Treated in Childhood with Surgery for Diaphragmatic Hernia and Adhesiolysis for Intestinal Obstruction.
BACKGROUND Wandering spleen (WS) is a rare medical condition in which the spleen migrates from its usual position commonly to the pelvis or lower abdomen assuming an ever-wandering state. The incidence of ectopic spleen is 0.2%, with variable clinical manifestations from asymptomatic to abdominal emergency. Symptoms are most attributed to complications related to torsion, so that a nonoperative management of a WS is not advised. According to the literature, 69.5% of patients with WS need splenectomy and 78.6% need laparotomy. CASE REPORT The patient exhibited vague intermittent lower abdominal pain for 6 months due to progressive torsion of the spleen, which resulted in venous congestion. Abdominal investigation revealed a mobile intra-abdominal mass and parenchymatous consistency in the pelvis. Diagnosis by computed tomography outlined abdominal splenomegaly with abnormal position both of pancreas and stomach. Laparoscopy established a giant spleen, with a lengthened pelvic and twisty vascular pedicle. In its ectopic location, the spleen had dragged the pancreas with it, which had taken a vertical position. The classic splenic ligaments were not recognizable. Spleen was removed with median laparotomic incision. Splenectomy was performed to prevent any traumatic fractures of the spleen, a complete twist of the splenic hilum, and the onset of recurrent acute pancreatitis. CONCLUSIONS Wandering spleen is rare in patients presenting with acute abdominal pain. An approach supported by clinical findings and investigation, even considering splenectomy over splenopexy, and laparoscopy over open surgery, may solve and prevent complications and health risks.
Topics: Abdominal Pain; Acute Disease; Female; Hernia, Hiatal; Hernias, Diaphragmatic, Congenital; Humans; Intestinal Obstruction; Laparoscopy; Pancreatitis; Pelvis; Splenectomy; Splenomegaly; Wandering Spleen
PubMed: 36184835
DOI: 10.12659/AJCR.936964 -
Frontiers in Surgery 2022Wandering spleen is a rare disease that is easily misdiagnosed. When combined with splenic pedicle torsion and even splenic infarction, wandering spleen is a rare and...
Wandering spleen is a rare disease that is easily misdiagnosed. When combined with splenic pedicle torsion and even splenic infarction, wandering spleen is a rare and critical cause of surgical acute abdomen. We report an 18-year-old male patient with abdominal organ inversion diagnosed as acute appendicitis before operation. Laparoscopic exploration confirmed wandering spleen with splenic pedicle torsion led to splenic infarction and was complicated by appendicitis. He was treated with laparoscopic appendectomy and abdominal splenectomy. The patient recovered well after the operation and was discharged from the hospital in 7 days. During the 4-year follow-up, there was no report of complicated infections such as pneumonia or sepsis.
PubMed: 36147692
DOI: 10.3389/fsurg.2022.916426 -
Surgical Case Reports Sep 2022Congenital diaphragmatic hernia (CDH) is sometimes associated with complications involving herniation of intrathoracic organs, which further increase mortality rate. We...
BACKGROUND
Congenital diaphragmatic hernia (CDH) is sometimes associated with complications involving herniation of intrathoracic organs, which further increase mortality rate. We encountered a case of postoperative gastric and splenic volvulus shortly after left CDH repair in a female neonate who was treated with gastropexy.
CASE PRESENTATION
At 39 weeks gestation, a female patient with left Bochdalek CDH was delivered (birth weight: 3748 g, Apgar score: 3/4). The patient was provided ventilator support with nitric oxide. After pulmonary hypertension improved, CDH repair was performed via the abdominal approach on day 7. The stomach, small intestine, large intestine, and spleen were herniated through a diaphragmatic defect of 4 × 2 cm. Although the diaphragm was directly closed, it was tight and the reconstructed diaphragm "dome" was shallow, restricting space for the spleen and stomach. Nonetheless, the spleen was positioned in the left upper abdomen and the stomach was positioned medially. The postoperative course was complicated by organo-axial gastric volvulus, and laparotomy was performed on day 14. In addition to the gastric volvulus, we confirmed a wandering splenic volvulus. The spleen was easily detorted and returned to the left upper abdomen. However, the patient experienced relapse of gastric volvulus without splenic volvulus. Gastropexy was performed electively on day 47. Postoperatively, the patient could be fed orally, and the patient's development was satisfactory 6 years after surgery.
CONCLUSIONS
The cause of these rare complications appeared to be tight direct diaphragmatic closure, which reduced space for the spleen and stomach beneath the left diaphragm.
PubMed: 36138238
DOI: 10.1186/s40792-022-01537-z -
Ulusal Travma Ve Acil Cerrahi Dergisi =... Sep 2022There are many causes of acute abdominal pain. One of them is wandering splenic torsion. We aimed to discuss a case in which the distal pancreas and spleen were torsion...
There are many causes of acute abdominal pain. One of them is wandering splenic torsion. We aimed to discuss a case in which the distal pancreas and spleen were torsion together and underwent splenectomy in the light of the literature. A 19-year-old male patient with sudden onset of abdominal pain underwent splenectomy after physical examination and imaging revealed splenic torsion. Early diagnosis is important as life-threatening complications may develop. Emergency surgery should be performed in patients with splenic ischemia. It should be kept in mind that the pancreas may be torsioned along with the spleen. Surgeons need to be careful during splenectomy to avoid injury to the pancreas.
Topics: Abdominal Pain; Adult; Humans; Male; Pancreas; Splenectomy; Tomography, X-Ray Computed; Torsion Abnormality; Wandering Spleen; Young Adult
PubMed: 36043920
DOI: 10.14744/tjtes.2021.34288 -
The Journal of Pediatrics Dec 2022
Topics: Humans; Child; Splenic Diseases; Torsion Abnormality; Splenectomy
PubMed: 36007577
DOI: 10.1016/j.jpeds.2022.08.021 -
Asian Journal of Surgery Feb 2023
Topics: Humans; Child; Wandering Spleen; Splenectomy
PubMed: 35999102
DOI: 10.1016/j.asjsur.2022.08.031 -
Radiology Case Reports Sep 2022Wandering spleen, also known as ectopic spleen, is a rare condition in which the spleen's anatomical location is other than its fixed position in the abdomen's left...
Wandering spleen, also known as ectopic spleen, is a rare condition in which the spleen's anatomical location is other than its fixed position in the abdomen's left upper quadrant. The cause of such an abnormality could be due to congenital or acquired factors, which could ultimately lead to torsion and splenic infarct. Given the nonspecific clinical symptoms and the potential complications associated with wandering spleen, computed tomography scans provide a crucial means for proper diagnosis. In this article, we report the case of a 16-year-old female with a diagnosis of wandering spleen with torsion and splenic infarct.
PubMed: 35874869
DOI: 10.1016/j.radcr.2022.06.073