J Korean Radiol Soc.
1988 Dec;24(6):1144-1150. 10.3348/jkrs.1988.24.6.1144.
Torsion of the wandering spleen: a case report
- KMID: 2359194
- DOI: http://doi.org/10.3348/jkrs.1988.24.6.1144
Abstract
- The wandering spleen is a rare anomaly(1). Preoperative diagnosis is difficult unless serious compicationsdevelop(2). Torsion of the spleen is one of the less common surgical conditions(3). This report documents atypical case of torision of the wandering spleen with review of radiologic findings and literatures. The patientwas 8-year-old female, whose complaints were epigastric pain and vomiting. A huge abdominal mass was palpated inright midabdomen. A plain radiograph of the abdomen demostarated a large soft tissue mass, which was located atright midabdomen transversely. A barium enema showed the mass the be extrinsic to the colon, with inferiordisplacement of the emidportion of transverse colon. The sonography revealed a spleen-shaped solid mass inmidabdomen and absence of the splenic echo in its normally identifiable position. As the results of sonographymthe wandering spleen was strongly suspected. A99mTc-sulfa colloid scan revealed a normal liver with the absence ofsplenic uptake, presumable secondary the the twisting of the splenic flexure area. Angiography was the mostdefinitive diagnostic modality in the evaluation of wandering spleen. Celiac angiography revealed an enlargedwandering spleen with no evidence of torsion. The splenic artery was elongated and displaced to right side, whicharose from common hepatic artery. Left gastric artery was also stretched. Surgery was done. The spleen was12x9x5cm in size and discolored to dark reddish. The splenic vessels were dilated with twisted splenic vascularpedicle. A splenectomy was performed. The interstitial hemorrhage of spleen was reported on pathologica finding.
