Korean J Hematol.  2005 Dec;40(4):278-281. 10.5045/kjh.2005.40.4.278.

Acute Torsion of a Wandering Spleen Managed by Splenopexy

• Park KS
• Shin MS
• Kim SY
• Sul JY
• Lee KS

• KMID: 2083468
• DOI: http://doi.org/10.5045/kjh.2005.40.4.278

Abstract

Torsion of the spleen is a rare cause of abdominal pain in children and it may occur in conjunction with wandering spleen. Wandering spleen is the presence of the spleen in a location other than the left upper quadrant, and it is secondary to the congenital or functional absence of splenic ligaments. The occurrence of wandering spleen is rare in adults and it's even less common in children. The most common presentation is acute abdominal pain, although the signs and symptoms vary widely. Due to the risk of splenic infarction, making a rapid and accurate diagnosis is essential. When a wandering spleen is diagnosed, the treatment of choice is splenopexy, even if the patient is asymptomatic. If splenic necrosis is present, then splenectomy is usually required. We describe here a 4-year-old girl with torsion of a wandering spleen that was managed by splenopexy.

Keyword

Wandering spleen; Torsion; Splenopexy

MeSH Terms

Abdominal Pain
Adult
Child
Child, Preschool
Diagnosis
Female
Humans
Ligaments
Necrosis
Spleen
Splenectomy
Splenic Infarction
Wandering Spleen*

Figure

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  Fig. 1. (A) Normal spleen shadow is shown in supine position. (B) But at erect position, spleen shadow is shown in the lower-medial of normal position.

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  Fig. 2. Abdominal CT. Hypoperfusion of enlarged spleen on contrast enhanced scan, suggesting splenic infarction.

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  Fig. 3. Ischemic change of the spleen has taken place. Mobile wandering spleen with no attachment except the main vascular pedicle. 360 degree torsion of splenic hilum is shown, and also inflammation of surrounding tissues.

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