Argüello BE, Canseco GR, Alanis CGA, Marrufo SE

Language: Spanish
References: 12
Page: 20-23
PDF size: 161.25 Kb.

ABSTRACT

Wandering spleen is an uncommon condition caused by the absence or hyperlaxity of the splenic ligaments, allowing its displacement into the lower abdomen and leaving it suspended solely by its elongated vascular pedicle. This pathology can be asymptomatic or present with acute or chronic abdominal pain, depending on the extent of pedicle torsion and the degree of vascular compromise.
We present the case of a 4-year-old pediatric patient who was admitted to the emergency department with an acute abdomen following abdominal trauma. During exploratory laparotomy, splenic pedicle torsion with splenic necrosis was identified, necessitating a splenectomy.
The diagnosis was supported by imaging findings of splenomegaly and extensive subcapsular hemorrhage, while intraoperative analysis revealed a 12 cm spleen adhered to the gastrocolic omentum, with the absence of most splenic ligaments.
Although splenopexy is the treatment of choice for viable spleens, in this case, splenectomy was required due to the organ’s nonviability. This report emphasizes the importance of early diagnosis and timely surgical management to prevent complications associated with this rare condition.

REFERENCES

1. Viana C, Cristino H, Veiga C, Leão P. Splenic torsion, achallenging diagnosis: case report and review of literature.Int J Surg Case Rep. 2018;44:212-6.

2. Blouhos K, Boulas KA, Salpigktidis I, Barettas N. Ectopicspleen: an easily identifiable but commonly undiagnosedentity until manifestation of complications. Int J SurgCase Rep. 2014;5:451-4. doi:10.1016/j.ijscr.2014.05.010.

3. Sayeed S, Koniaris LG, Kovach SJ, Hirokawa T. Torsionof wandering spleen. Surgery. 2002;132:535-6.

4. Puranik A, Mehra R, Chauhan S, Pandey R. Wanderingspleen: a surgical enigma. Gastroenterol Rep. 2015;1-3.

5. Ityel H, Granot Y, Vaknine H, Judich A, Shimonov M.Splenic torsion of a wandering spleen. Isr Med Assoc J.2011;13:119-20.

6. Moran JC, Shah U, Singer JA. Spontaneous rupture of awandering spleen: case report and literature review. CurrSurg. 2003;60:310-2.

7. Maestre-Serrano RY, Acevedo-Reyes H, Cohen-Ríos S,Álvarez-Jiménez J. Bazo errante gigante con torsión delpedículo e infarto esplénico: reporte de un caso. Rev Cir[Internet]. 2019 Jun [citado 2024 Jul 15];71(3):257-60.Disponible en: https://tinyurl.com/28h3tqxp

8. Maestre-Serrano RY, Acevedo-Reyes H, Cohen-Ríos S,Álvarez-Jiménez J. Bazo errante gigante con torsión delpedículo e infarto esplénico: reporte de un caso. Rev Cir.2019;71(3):257-60.

9. Saldívar-Martínez DE, Galindo-Sánchez HM, Fonseca-Sada I, Marcos-Ramírez ER, Vázquez-Fernández F. Bazoerrante infartado y vólvulo de cola de páncreas en un pacientecon hernia de Grynfelt-Lesshaft concomitante. CirCir. 2021;89(Suppl 1):20-2.

10. Cerdán Pascual R, Bernal Jaulín J, Cantín Blázquez S, PaternaLópez S, Barranco Domínguez JI, Esarte MuniainJM. Bazo errante y torsionado: presentación de un caso.Cir Gen. 2006;28(4).

11. Sojo-Rodríguez V, Cañete-Gómez J, Olivares C, Reguera-Rosal J, Segura-Sampedro JJ, Camacho-Marente V, et al.Abdomen agudo secundario a torsión de bazo ectópico.Rev Esp Enferm Dig. 2015;107(4):229-30.

12. Serrano RY, Acevedo-Reyes H, Cohen-Ríos S, Álvarez-Jiménez J. Bazo errante gigante con torsión del pedículoe infarto esplénico: reporte de un caso [Internet]. Scielo.cl [citado 2024 Jul 15]. Disponible en: https://www.scielo.cl/pdf/revistacirugia/v71n3/2452-4549-revistacirugia-71-03-0257.pdf