Wandering spleen--the challenge of ultrasound diagnosis: report of 7 cases.
OBJECTIVE
To summarize our experience with sonographic diagnosis of wandering spleen in children and assess for the typical sonographic findings of wandering spleen, complications, and possible diagnostic pitfalls.


METHODS
We identified all pediatric patients from 1998-2003 with a surgically confirmed diagnosis of wandering spleen. All sonographic examinations were reviewed for splenic position, size, echotexture, and parenchymal blood flow.


RESULTS
Seven children were identified with a mean age of 9.7 years (range 4.2-15.3 years). All presented with abdominal pain. Abdominal sonography, performed in all children demonstrated a low position of the spleen (n = 6), splenomegaly (n = 4), and absence of parenchymal flow in the three patients with splenic torsion and infarction. The diagnosis was made preoperatively via sonography in five children; three required repeated hospital admissions before the correct diagnosis was established. Complications occurred in five patients (gastric obstruction [n = 1], splenic infarction [n = 3], and recurrent pancreatitis [n = 1]).


CONCLUSIONS
The most specific sonographic finding for wandering spleen is low position of the spleen. However, if the spleen regains its normal or near-normal position, the diagnosis may be missed and the condition may recur, and result in complications.
Karmazyn
Boaz
B
Department of Pediatric Radiology, Schneider Children's Medical Center of Israel, Petah Tiqva, Israel.
Steinberg
Ran
R
Gayer
Gabriella
G
Grozovski
Sylvia
S
Freud
Enrique
E
Kornreich
Liora
L
D015746:Abdominal Pain / Q000209:etiology*; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D011300:Preoperative Care; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014102:Torsion Abnormality; D014463:Ultrasonography; D050805:Wandering Spleen / Q000000981:diagnostic imaging* / Q000601:surgery