Wandering spleen in children: multicenter retrospective study.
Wandering spleen in children is a rare condition. The diagnosis is difficult, and any delay can cause splenic ischemia. An epidemiologic, semiological, and surgical diagnosis questionnaire on incidence of wandering spleen in children was sent to several French surgical teams. We report the results of this multicenter retrospective study. Fourteen cases (6 girls, 8 boys) were reported between 1984 and 2009; the age range varies between 1-day-old and 15 years; 86% were seen in the emergency department. Ninety-three percent had diffuse abdominal pain. For 57% of the cases, it was their first symptomatic episode of this type. No diagnosis was established based on the clinical results alone. All patients had presurgical imaging diagnosis. Open surgery was performed on 64% cases. Forty-three had splenectomy for splenic ischemia. Thirty-six percent had splenopexy, 14% had laparoscopic gastropexy, and 7% had spleen repositioning and regeneration. Complications were noted in 60% of the cases resulting in postsplenopexy splenic ischemia. Early diagnosis and surgery are the best guarantee for spleen preservation. Even if the choice of one technique, splenopexy or gastropexy, can be argued, gastropexy has the advantage of avoiding splenic manipulation and restoring proper physiologic anatomy. When there is no history of abdominal surgery, laparoscopy surgery seems the best procedure.
Fiquet-Francois
Caroline
C
Pediatric Surgery Department, American Memorial Hospital, Centre Hospitalier Universitaire, 51092 Reims France. carolinefiquet@me.com
Belouadah
Mohamed
M
Ludot
Hugues
H
Defauw
Benoit
B
Mcheik
Jiad Noel
JN
Bonnet
Jean Paul
JP
Kanmegne
Charly Udozen
CU
Weil
Dominique
D
Coupry
Lionel
L
Fremont
Benjamin
B
Becmeur
Francois
F
Lacreuse
Isabelle
I
Montupet
Philippe
P
Rahal
Eliane
E
Botto
Nathalie
N
Cheikhelard
Alaa
A
Sarnacki
Sabine
S
Petit
Thierry
T
Poli Merol
Marie Laurence
ML
D015746:Abdominal Pain / Q000209:etiology; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007813:Laparotomy; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome; D050805:Wandering Spleen / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*