Wandering spleen as a cause of acute abdomen: a case report.
We report a case of acute abdomen due to torsion of the long vascular pedicle of a wandering spleen, displaced in the abdominal cavity, and caused by partial infarction of the spleen. The 46-year-old patient presented to the casualty department with piercing abdominal pain, fever, vomiting, leukocytosis, thrombocytopenia, and a palpable mass in the mesogastric region. US and CT scan revealed the presence of a mass compatible with an ectopic spleen in the mesohypogastric region, featuring necrotic-haemorrhagic areas, a long, contorted vascular pedicle twisted on its axis, and an empty splenic space. We performed an emergency laparoscopic splenectomy. Conservative surgery (splenopexy) could not be done because of the severe impairment of the vascular supply to the organ. Nowadays, conservative surgery is preferred in cases without vascular impairment, especially in children, by creating an omental or synthetic pouch after fixing the organ in the splenic space.
Puglisi
Francesco
F
AUSL FG2 - Hospital of Manfredonia - Manfredonia, Foggia.
Potenza
Antonio
A
Melchionda
Matteo
M
Capuano
Palma
P
De Fazio
Michele
M
Lobascio
Pierluigi
P
Martines
Gennaro
G
Lograno
Giuseppe
G
D000006:Abdomen, Acute / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D013154:Spleen / Q000002:abnormalities*; D013156:Splenectomy; D013158:Splenic Diseases / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D014102:Torsion Abnormality; D016896:Treatment Outcome