Acute Torsion of a Wandering Spleen Managed by Splenopexy

Kyoung Soo Park; Myung Seok Shin; Sun Young Kim; Ji Young Sul; Keon Su Lee

doi:10.5045/kjh.2005.40.4.278

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Park, Shin, Kim, Sul, and Lee: Acute Torsion of a Wandering Spleen Managed by Splenopexy

Case Report

Korean J Hematol 2005;40(4):278-281.

Published online: 21 December 2005

DOI: https://doi.org/10.5045/kjh.2005.40.4.278

Acute Torsion of a Wandering Spleen Managed by Splenopexy

Kyoung Soo Park, M.D.¹, Myung Seok Shin, M.D.¹, Sun Young Kim, M.D.¹, Ji Young Sul, M.D.², Keon Su Lee, M.D.¹

¹Department of Pediatrics, Chungnam National University College of Medicine, Daejeon, Korea

²Department of Surgery, Chungnam National University College of Medicine, Daejeon, Korea

Correspondence to: Sun Young Kim, M.D. Department of Pediatrics, Chungnam National University College of Medicine 640 Daesa-dong, Jung-gu, Daejeon 301-721, Korea Tel: +82-42-220-7252, Fax: +82-42-255-3158 E-mail: sunyoung@cnuh.co.kr

Received 18 October 2005 Revised 14 November 2005 Accepted 25 November 2005

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.

Keywords: Wandering spleen, Torsion, Splenopexy

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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.

Fig. 2.

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

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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