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At least 19 recordsLinked to original sources
PubMed2002

Acute abdomen due to torsion of a pelvic wandering spleen.

Wandering spleen is a rare entity characterized by incomplete fixation of the spleen by lienorenal and gastrosplenic ligaments. Wandering spleen can migrate to the lower abdomen or pelvis, and can be either congenital or acquired. It is most commonly found in women of reproductive age, and may be misdiagnosed as an abdominal or adnexal mass. It is usually asymptomatic, but may present with acute, chronic, or intermittent abdominal pain. Here, we report a case of torsion of a huge congenital pelvic wandering spleen and microscopic isolated pancreatic tissue (disconnected from the pancreas) with impending splenic rupture in a 23-year-old female patient. Progressively severe chronic or intermittent torsion of the vascular pedicle of the wandering spleen caused progressive intermittent lower abdominal pain. The patient underwent splenectomy with resection of the long pedicle and the postoperative course was uneventful. The pathognomonic computerized tomography features of this case, including absence of the spleen in the left upper quadrant and the presence of a whirl-like structure running down to the central portion of the distally located large soft-tissue mass and with a notched- (hilar-) like contour, are also described.

Abdomen, Acute↗
PubMed1998

Laparoscopic splenopexy for pediatric wandering spleen.

Wandering spleen is an uncommon condition, showing a splenic hypermobility that results from laxity or maldevelopment of its suspensory ligament. This condition results in constant danger of splenic torsion and infarction. Wandering spleen was diagnosed in a 2-year-old girl who complained of intermittent abdominal pain, and viability of the spleen was confirmed by doppler ultrasound scan. Elective laparoscopic splenopexy was performed by anchoring the spleen wrapped in absorbable mesh. To our knowledge, this is the first reported case of laparoscopic splenopexy for wandering spleen. The authors believe that this approach is a safe and effective procedure for wandering spleen with the advantage of minimally invasive surgery.

Child, Preschool↗
PubMed2006

[Laparoscopic splenectomy due to torsion of a wandering spleen].

Wandering spleen is an uncommon entity, characterized by the anomalous position of the spleen, caused by the absence or laxity of its suspensory ligaments. The most common symptoms are usually due to intermittent or complete torsion of the splenic pedicle with subsequent infarction. We report a case of torsion of a wandering spleen. Laparoscopic splenectomy was performed and recovery was uneventful. Although few cases of wandering spleen treated laparoscopically have been reported in the literature, laparoscopy has been demonstrated to be a safe technique for the treatment of this entity.

Adult↗
PubMed2004

Laparoscopic management of the wandering spleen.

Wandering spleen is a rare clinical condition associated with a high incidence of splenic torsion and infarction. The preferred treatment for this condition is splenopexy to reposition the spleen in the left upper quadrant of the abdomen and to preserve splenic function. We present two cases of wandering spleen managed by laparoscopic splenopexy. Both young women presented with intermittent abdominal pain. A CT scan was diagnostic of wandering spleen in each case. Both patients were successfully treated with the laparoscopic splenopexy. The spleen was inserted in a Vicryl mesh bag and fixed in the left upper quadrant in both cases. Both patients had resolution of their preoperative symptoms. Laparoscopic splenopexy has many advantages over open splenopexy or splenectomy, including preserving splenic function, minimal postoperative pain, early discharge from the hospital, and rapid recovery.

Abdominal Pain↗
PubMedDate not supplied

Reversible hypersplenism after splenopexy for wandering spleen.

Wandering spleen is a rare condition characterized by a normal spleen with extreme mobility associated with an elongated pedicle. The most common presentation is an acute surgical abdomen related to acute torsion. A case of wandering spleen complicated by symptomatic hypersplenism in a 29 year-old woman is presented. The hypersplenism was diagnosed after bleeding delivery, requiring blood transfusion. Wandering spleen was suspected after pre-operatively performed CT scan. The patient was successfully treated by splenopexy. This report illustrates that conservative surgical management may result in complete reversal of hematological symptoms.

Adult↗
PubMed2001

Laparoscopic splenopexy by peritoneal and omental pouch construction for intermittent splenic torsion ("wandering spleen").

Wandering spleen is an extremely rare anatomic variant with potentially serious clinical implications. Usually, splenectomy is advocated for treatment of this disease. Various methods for preserving the wandering spleen by means of splenopexy have been described, including two reports on laparoscopic splenic refixation. We describe the third case in which laparoscopic splenopexy was used to manage chronic intermittent splenic torsion. In a 25-year-old woman, splenopexy was successfully performed by laparoscopic reposition and fixation of the spleen by omental pouch creation. At laparoscopy with a normal operating room setup and four trocars, a free-floating, macroscopically normal spleen attached to an abnormally long vascular pedicle with no gastrosplenic or phrenicosplenic ligaments was detected in the lower right quadrant. The spleen was repositioned and placed in the left phrenorenal angle. Splenopexy was achieved by suturing the left colophrenic ligament to the lateral diaphragm, thus creating a pouch for the inferior part of the spleen, and by suturing the gastrocolic ligament to the anterior diaphragm to create a pouch for the upper splenic pole. The postoperative course was uneventful. At a follow-up examination 3 months after the operation, the patient was well, with no further episode of recurrent abdominal pain. Ultrasonographically, the spleen was seen easily in the left hypochondrium in its normal physiologic position. Laparoscopic splenopexy is a useful option for organ-preserving therapy of the wandering spleen.

Adult↗
PubMed2005

Pseudocyst formation: a rare complication of wandering spleen.

Wandering spleen is a rare entity, in which the spleen is abnormally mobile due to its attachment by a long vascular pedicle. This long vascular pedicle predisposes it to various complications, the most common being torsion. Here, we present a case in which a wandering spleen in a young female was complicated by pseudocyst formation, and discuss the possible aetiology, pathogenesis, diagnosis and therapeutic implications of this extremely rare complication.

Abdominal Pain↗
PubMed1995

The value of combined 99mTc-Sn-colloid and 99mTc-RBC scintigraphy in the evaluation of a wandering spleen.

Wandering spleen is the term commonly applied to splenic hypermobility that results from laxity or maldevelopment of its suspensory ligaments. It comes to medical attention usually as an abdominal mass, or when the spleen undergoes torsion. Diagnosis on clinical grounds alone is rarely made, and ultrasonography, CT and MRI findings have no specific characteristics for this condition. 99mTc-labeled colloid taken up by the spleen may provide a specific diagnosis. We report a case of wandering spleen, in which the preoperative diagnosis was made on the basis of sequential liver-spleen scintigraphy with 99mTc-Sn-colloid and blood-pool scintigraphy with 99mTc-RBC. This is a rare case, in which hypermobility was assessed by sequential 99mTc-Sn-colloid scintigraphy, and to our knowledge, is the first case in which 99mTc-RBC scintigraphy provided useful information on splenic blood volume and its location.

Adult↗
PubMed1981

Splenopexy in a case of wandering spleen.

Wandering spleen is a rare condition, commonly treated with splenectomy. Authors report a case of wandering spleen, preoperatively diagnosed, and successfully treated with splenopexy.

Child, Preschool↗
PubMed2004

Laparoscopic splenectomy for the treatment of wandering spleen.

Wandering spleen is a very rare pathologic condition that initially presents with unremarkable clinical symptoms, then dramatically manifests severe complications. A case of wandering spleen treated with laparoscopic splenectomy is described and compared with other similar reports in the literature. Laparoscopic exploration of the abdominal cavity allowed the diagnosis to be confirmed and splenectomy to be performed. An enlarged spleen led to the choice of total splenectomy to avoid both future complications and future organ torsion resulting from the long and twisted vascular pedicle. The laparoscopic approach led to a rapid recovery, a 3-day postoperative course, and satisfactory cosmetic results.

Adult↗
PubMed1992

The wandering spleen.

Wandering spleen is an unusual entity, occurring in both sexes and at any age, but is more frequent in women of reproductive age and in children. Wandering spleen is probably most often a result of congenital anomalies of development of the dorsal mesogastrium, but acquired factors may have a role in certain instances. Patients present most commonly with an asymptomatic mass, mass and subacute abdominal or gastrointestinal complaints or with acute abdominal findings. Clinical diagnosis can be difficult, but noninvasive imaging procedures, such as sonography, nuclear scintigraphy, computed tomography and magnetic resonance imaging are usually diagnostic. Laboratory tests are usually nonspecific, but may occasionally reveal evidence of hypersplenism or functional splenia. Symptoms may remain limited or absent for long periods of time, but complications related to torsion or compression of abdominal organs by the spleen or the pedicle are quite common. Splenomegaly is usually a result of torsion of the pedicle and splenic sequestration. Significant morbidity and mortality rates seem to be considerably less than described in 1933 and limited primarily to patients presenting initially with acute abdominal findings. Management recommendations have varied, but recognition of a significant risk of postsplenectomy sepsis supports a conservative approach. Patients with limited symptomatology may be medically managed until they exhibit worsening symptoms indicating progressive splenic torsion or gastrointestinal compression. Detorsion and splenopexy may be considered a reasonable surgical option even in patients presenting with acute abdomen, if there is no evidence of infarction, thrombosis or hypersplenism. Splenic preservation is especially recommended in extremely young patients who are at particular risk for postsplenectomy sepsis. However, it should be noted that follow-up evaluation data on splenopexy patients are notably lacking. Splenectomy is ideally reserved for patients presenting with acute abdomen and splenic infarction or thrombosis or with hypersplenism and patients in whom splenopexy is technically unfeasible. Subtotal splenectomy and splenic autotransplantation may be of limited value. Pneumococcal, Hemophilus and meningococcal vaccines are indicated before elective splenectomy and shortly after nonelective splenectomy. Antibiotic prophylaxis is recommended for those at particular risk. Prospective studies are unlikely, but extended follow-up information on patients already reported, particularly those managed expectantly or with conservative surgical measures, is needed.

Congenital Abnormalities↗
PubMed1996

The wandering spleen.

Wandering spleen is a rare condition that commonly presents with splenic infarction secondary to torsion. Splenectomy was previously advocated as the treatment of choice, though recent reports suggest that the organ may be distorted, and splenopexy performed. This paper documents how the latter procedure may be done using adherent omentum.

Child↗
PubMed2004

Splenic haemorrhage in a newborn as the first manifestation of wandering spleen syndrome.

Wandering spleen is an unusual condition in children and is even more rarely diagnosed in the neonatal period. A case of splenic haemorrhage after dystocic birth in a newborn is reported. Before surgery, results of imaging studies were suggestive of a ruptured spleen. On laparotomy, a big haematoma surrounding a wandering spleen was found. Haemorrhage aroused from short splenic arteria. Haemostasia and splenopexy were performed. The spleen proved later to be viable. The authors speculate that the haemorrhage was the first manifestation of the wandering spleen.

Adult↗
PubMed2000

Power Doppler sonographic diagnosis of torsion in a wandering spleen.

A wandering spleen is a rare clinical entity resulting from congenital maldevelopment or acquired laxity of the spleen's suspensory ligaments; it may result in torsion of the spleen. We report the gray-scale sonographic, power Doppler sonographic, and CT findings in a case of wandering spleen torsion. The gray-scale sonograms showed a displaced spleen that appeared as a homogeneous, hypoechoic mass suggestive of an enlarged, ectopic spleen in the central abdomen. Power Doppler sonograms showed no blood flow in the parenchyma or hilum of the spleen and were consistent with torsion and infarction in the spleen. Contrast-enhanced CT scans showed a homogeneous, unenhanced mass that was diagnosed as a torsioned wandering spleen. The hilar vessels of the spleen were also unenhanced.

Adult↗
PubMed1992

The splenic snood: an improved approach for the management of the wandering spleen.

A wandering spleen is in constant danger of torsion and infarction. Splenectomy, the traditional treatment, leaves children in danger of postsplenectomy sepsis. Three children with wandering spleens were treated by a new splenopexy technique, the splenic snood. After detorsion, the spleens were wrapped in polyglycolic mesh and anchored by the mesh subdiaphragmatically in the left upper quadrant. All have retained their spleens which have remained where anchored up to a 4-year follow-up. The simplicity and technical ease of the splenic snood operation recommend it as an improved method to avoid splenectomy and safely normalize intraabdominal anatomy in the management of the wandering spleen.

Child↗
PubMed1998

Epidermoid cyst in a wandering spleen.

A wandering spleen and splenic cysts are uncommon conditions in children. A combination of both entities has only rarely been reported in the literature. Another case of this complex pathology in 12-year-old girl is presented. She was initially referred for evaluation of a large abdominal mass. Diagnostic studies raised the suspicion of a hematoma in an abnormally located spleen, but the definitive diagnosis was established at laparotomy. Successful surgical management consisted of total cystectomy and splenopexy.

Abdominal Neoplasms↗
PubMed2002

Clinical presentation of wandering spleen.

BACKGROUND: Wandering spleen (WS) is an uncommon condition with a variety of clinical presentations. METHODS: The medical files of 5 children who underwent operation for WS in the authors' department during the period 1996 through 2000 were retrospectively reviewed. RESULTS: Splenic salvage procedures (retroperitoneal splenopexy) were performed in 4 patients. One patient underwent splenectomy because of splenic necrosis. CONCLUSIONS: Early diagnosis and surgical treatment is mandatory to prevent complications. Every effort should be made to preserve the spleen, especially among the pediatric population, and splenopexy is the procedure of choice even in the asymptomatic patient.

Adolescent↗