Splenic torsion. An unusual cause of splenomegaly

Spontaneous rupture of a wandering spleen: case report and literature review

Wandering spleen is a rare clinical entity. The etiology is not precisely known, and the management is controversial. Patients may become symptomatic when torsion of the pedicle results in pain, ischemia, infarction, or rupture. We present a spontaneous rupture of a wandering spleen without any history of trauma.

The wandering spleen

Wandering spleen is a rare condition that commonly presents with splenic infarction secondary to torsion. Splenectomy was previously advocated as the treatment of choice, though recent reports suggest that the organ may be distorted, and splenopexy performed. This paper documents how the latter procedure may be done using adherent omentum.

Torsion of wandering spleen: the whorled appearance of the splenic pedicle on CT

Congenital deficiency or acquired laxity of the suspensory ligaments of the spleen may result in extreme splenic mobility. This rare condition, which is termed wandering or ectopic spleen predisposes the elongated splenic pedicle to torsion. We present a case of splenic torsion with a new CT finding consisting of a whorled appearance of the splenic pedicle. To our knowledge this finding has not been described before.

Elective splenopexy for wandering spleen

The diagnosis of wandering spleen is usually made at the time of operation owing to symptoms caused by torsion of the spleen. Splenectomy has been performed in almost all of the reported cases. A 6-year-old girl presented with intermittent abdominal pain and a mobile abdominal mass. The diagnosis of wandering spleen was confirmed by computerized tomography. Elective splenopexy was performed by securing the spleen in an extraperitoneal pocket.

A torted pelvic spleen

An unusual case of an acute abdomen due to a torted wandering spleen in the pelvis is presented. As is usual for the few cases reported, the diagnosis was unsuspected pre-operatively. The treatment is splenectomy and a quick and complete recovery followed this. Literature on the subject is reviewed.