Wandering Spleen Volvulus: A Case Report and Literature Review of This Diagnostic Challenge.

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Version: Final published version
License: CC BY-NC-ND 4.0
Serval ID
serval:BIB_10372C58D453
Type
Article: article from journal or magazin.
Publication sub-type
Case report (case report): feedback on an observation with a short commentary.
Collection
Publications
Institution
Title
Wandering Spleen Volvulus: A Case Report and Literature Review of This Diagnostic Challenge.
Journal
The American journal of case reports
Author(s)
Koliakos E., Papazarkadas X., Sleiman M.J., Rotas I., Christodoulou M.
ISSN
1941-5923 (Electronic)
ISSN-L
1941-5923
Publication state
Published
Issued date
01/09/2020
Peer-reviewed
Oui
Volume
21
Pages
e925301
Language
english
Notes
Publication types: Case Reports ; Journal Article ; Review
Publication Status: epublish
Abstract
BACKGROUND Wandering spleen is a rare condition in which the spleen lacks the usual peritoneal attachments, resulting in increased intra-abdominal mobility. Complications can occur due to the torsion of the splenic vascular pedicle, resulting in symptoms ranging from an incidental finding to an acute abdomen as a result of an ischemic necrosis of the spleen. CASE REPORT We present the case of a 25-year-old female patient who presented with a recurring abdominal pain associated with serum lipase and C-reactive protein elevation. The computed tomography scan revealed torsion of the splenic pedicle and hypoperfusion of the spleen. A surgical exploration was performed and a wandering spleen was diagnosed perioperatively. It was characterized by the lack of peritoneal ligaments, thus resulting in a splenic volvulus. A splenectomy was carried out due to the definite ischemic necrosis of the spleen. CONCLUSIONS The diagnosis of this rare condition can be very challenging since it can be presented with a vast variety of symptoms, mimicking other abdominal pathologies. The intermittent nature of an ultimate splenic torsion can add to the diagnostic challenge. Medical literature concerning the wandering spleen and knowledge about this pathology originates mainly from individual case reports. Despite the evolving diagnostic modalities available, this rare and ambiguous disorder remains misdiagnosed, and a high index of suspicion is needed for the appropriate diagnosis to be established.
Keywords
Abdomen, Acute, Adult, Female, Humans, Intestinal Volvulus/diagnostic imaging, Intestinal Volvulus/surgery, Splenic Diseases, Torsion Abnormality/diagnostic imaging, Torsion Abnormality/surgery, Wandering Spleen/diagnostic imaging, Wandering Spleen/surgery
Pubmed
Web of science
Create date
09/09/2020 8:18
Last modification date
09/08/2024 14:55
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