Laparoscopic splenectomy for torsion of wandering spleen associated with celiac axis occlusion.
BACKGROUND
Wandering spleen is a spleen lacking its normal ligamentous attachments, and thus subjected to free movement in the abdominal cavity, and even torsion around its pedicle. Surgical treatment includes either fixation (splenopexy) or resection (splenectomy). Both procedures can now be accomplished using the laparoscopic approach.


RESULTS
We describe a case of a torsion of a wandering spleen, leading to recurrent episodes of abdominal pain, and eventually to splenic ischemia, necessitating splenectomy. The diagnosis was complicated by associated angiographic findings of celiac axis occlusion, possibly by median arcuate ligament compression. Laparoscopic splenectomy was successful, and led to complete resolution of symptoms.


CONCLUSIONS
Although a rare condition, wandering spleen can be diagnosed accurately by imaging studies, mainly CT scan and angiography. Nowadays, the laparoscopic approach is preferred and enables the surgeon to perform either splenopexy or splenectomy, depending on the vascular status of the spleen.
Rosin
D
D
Department of General Surgery and Transplantation, Sheba Medical Center, Tel Hashomer, Israel. drosin6424@aol.com
Bank
I
I
Gayer
G
G
Rimon
U
U
Gur
D
D
Kuriansky
Y
Y
Morag
B
B
Pras
M
M
Ayalon
A
A
D000328:Adult; D001157:Arterial Occlusive Diseases / Q000209:etiology* / Q000601:surgery*; D002445:Celiac Artery; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D013154:Spleen / Q000002:abnormalities* / Q000601:surgery*; D013156:Splenectomy / Q000379:methods*; D014102:Torsion Abnormality / Q000601:surgery