Laparoscopic splenopexy of a pediatric wandering spleen by creation of a retroperitoneal pocket.
Wandering spleen is a rare condition in which the spleen is attached by a long, vascular pedicle and lacks its usual peritoneal attachments and supporting ligaments. This condition predisposes the spleen to torsion and infarction. We report the case of a 2-year-old boy with a history of intermittent abdominal pain and early satiety who presented with abdominal pain and severe gastric distention. A work-up including computed tomographic and ultrasonographic imaging suggested a wandering spleen. The diagnosis was confirmed during laparoscopy, and splenopexy was performed by anchoring the spleen in a retroperitoneal pocket in the left upper quadrant at the level of the tenth rib. To our knowledge, this is the first reported case of minimally invasive splenopexy for wandering spleen that involves the creation of a retroperitoneal pocket without the use of mesh. The authors believe that this is a safe and effective method that takes advantage of laparoscopy and avoids the risk of infection and complications associated with the use of synthetic material.
Hedeshian
Mohir H
MH
Department of Surgery, Division of Pediatric Surgery, University of Massachusetts Medical School, Worcester, Massachusetts 01655, USA.
Hirsh
Michael P
MP
Danielson
Paul D
PD
D015746:Abdominal Pain / Q000209:etiology; D006801:Humans; D007223:Infant; D010535:Laparoscopy; D008297:Male; D013154:Spleen / Q000002:abnormalities*; D013158:Splenic Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography