BACKGROUND Wandering spleen is rare clinically.It is characterized by displacement of the spleen in the abdominal and pelvic cavities and can have congenital or acquired causes.Wandering spleen involves serious compli...BACKGROUND Wandering spleen is rare clinically.It is characterized by displacement of the spleen in the abdominal and pelvic cavities and can have congenital or acquired causes.Wandering spleen involves serious complications,such as spleen torsion.The clinical symptoms range from asymptomatic abdominal mass to acute abdominal pain.Surgery is required after diagnosis.Cases of wandering spleen torsion with portal vein thrombosis(PVT)are rare.There is no report on how to eliminate PVT in such cases.CASE SUMMARY Ultrasound and computed tomography revealed a diagnosis of wandering spleen torsion with PVT in a 31-year-old woman with a history of childbirth 16 mo previously who received emergency treatment for upper abdominal pain.She recovered well after splenectomy and portal vein thrombectomy combined with continuous anticoagulation,and the PVT disappeared.CONCLUSION Rare and nonspecific conditions,such as wandering splenic torsion with PVT,must be diagnosed and treated early.Patients with complete splenic infarction require splenectomy.Anticoagulation therapy and individualized management for PVT is feasible.展开更多
The displacement of spleen from its normal location to other places is known as wandering spleen(WS)and is a rare disease.The repeated torsion of WS is due to the presence of long pedicle and absence/laxity of anchori...The displacement of spleen from its normal location to other places is known as wandering spleen(WS)and is a rare disease.The repeated torsion of WS is due to the presence of long pedicle and absence/laxity of anchoring ligaments.A WS is an extremely rare cause of left-sided portal hypertension(PHT)and severe gastric variceal bleeding.Left-sided PHT usually occurs as a result of splenic vein occlusion caused by splenic torsion,extrinsic compression of the splenic pedicle by enlarged spleen,and splenic vein thrombosis.There is a paucity of data on WSrelated PHT,and these data are mostly in the form of case reports.In this review,we have analyzed the data of 20 reported cases of WS-related PHT.The mechanisms of pathogenesis,clinico-demographic profile,and clinical implications are described in this article.The majority of patients were diagnosed in the second to third decade of life(mean age:26 years),with a strong female preponderance(M:F=1:9).Eleven of the 20 WS patients with left-sided PHT presented with abdominal pain and mass.In 6 of the 11 patients,varices were detected incidentally on preoperative imaging studies or discovered intraoperatively.Therefore,pre-operative search for varices is required in patients with splenic torsion.展开更多
BACKGROUND The floating spleen refers to the spleen moving away from the normal anatomical position to other parts of the abdominal cavity.CASE SUMMARY In this report,we describe two cases of torsion of floating splee...BACKGROUND The floating spleen refers to the spleen moving away from the normal anatomical position to other parts of the abdominal cavity.CASE SUMMARY In this report,we describe two cases of torsion of floating spleen,which were successfully treated by laparoscopic partial splenectomy and retroperitoneal fixation of the residual spleen.The clinical characteristics of previously reported cases are also discussed.CONCLUSION In conclusion,laparoscopic partial resection of splenic volvulus infarction and extraperitoneal fixation of residual spleen are safe and reliable.展开更多
Wandering spleen,also referred to as‘ptotic spleen’,is a rare clinical condition characterized by splenicmigration form its normal left hypochondrial position to any other abdominal or pelvic position.Among themulti...Wandering spleen,also referred to as‘ptotic spleen’,is a rare clinical condition characterized by splenicmigration form its normal left hypochondrial position to any other abdominal or pelvic position.Among themultifactorial etiologies proposed,laxity of the spleen’s primary supporting ligaments is themost agreed-upon hypothesis.We present one rare case of wandering spleen in an 11-year-old girl who presented with recurrent abdominal pain with no localizing features.Her abdominal examination revealed an intra-abdominal left iliac fossa lump with restrictedmobility,which was confirmed as a wandering spleen by abdominal sonography and contrast-enhanced computed tomography.Intraoperatively,an infarcted spleen was encountered with tortuous,elongated,torsional splenic pedicle and a single dense adhesive band with descending colon.Splenectomy was offered to the patient.Post-operatively,the patient is healthy and symptom free at one-year follow-up.The rare clinical diagnosis of this condition,particularly in the paediatric age-group,makes it an enigma for the surgical world.展开更多
基金Supported by CACMS Innovation Fund,No.CI2021A03317.
文摘BACKGROUND Wandering spleen is rare clinically.It is characterized by displacement of the spleen in the abdominal and pelvic cavities and can have congenital or acquired causes.Wandering spleen involves serious complications,such as spleen torsion.The clinical symptoms range from asymptomatic abdominal mass to acute abdominal pain.Surgery is required after diagnosis.Cases of wandering spleen torsion with portal vein thrombosis(PVT)are rare.There is no report on how to eliminate PVT in such cases.CASE SUMMARY Ultrasound and computed tomography revealed a diagnosis of wandering spleen torsion with PVT in a 31-year-old woman with a history of childbirth 16 mo previously who received emergency treatment for upper abdominal pain.She recovered well after splenectomy and portal vein thrombectomy combined with continuous anticoagulation,and the PVT disappeared.CONCLUSION Rare and nonspecific conditions,such as wandering splenic torsion with PVT,must be diagnosed and treated early.Patients with complete splenic infarction require splenectomy.Anticoagulation therapy and individualized management for PVT is feasible.
文摘The displacement of spleen from its normal location to other places is known as wandering spleen(WS)and is a rare disease.The repeated torsion of WS is due to the presence of long pedicle and absence/laxity of anchoring ligaments.A WS is an extremely rare cause of left-sided portal hypertension(PHT)and severe gastric variceal bleeding.Left-sided PHT usually occurs as a result of splenic vein occlusion caused by splenic torsion,extrinsic compression of the splenic pedicle by enlarged spleen,and splenic vein thrombosis.There is a paucity of data on WSrelated PHT,and these data are mostly in the form of case reports.In this review,we have analyzed the data of 20 reported cases of WS-related PHT.The mechanisms of pathogenesis,clinico-demographic profile,and clinical implications are described in this article.The majority of patients were diagnosed in the second to third decade of life(mean age:26 years),with a strong female preponderance(M:F=1:9).Eleven of the 20 WS patients with left-sided PHT presented with abdominal pain and mass.In 6 of the 11 patients,varices were detected incidentally on preoperative imaging studies or discovered intraoperatively.Therefore,pre-operative search for varices is required in patients with splenic torsion.
文摘BACKGROUND The floating spleen refers to the spleen moving away from the normal anatomical position to other parts of the abdominal cavity.CASE SUMMARY In this report,we describe two cases of torsion of floating spleen,which were successfully treated by laparoscopic partial splenectomy and retroperitoneal fixation of the residual spleen.The clinical characteristics of previously reported cases are also discussed.CONCLUSION In conclusion,laparoscopic partial resection of splenic volvulus infarction and extraperitoneal fixation of residual spleen are safe and reliable.
文摘Wandering spleen,also referred to as‘ptotic spleen’,is a rare clinical condition characterized by splenicmigration form its normal left hypochondrial position to any other abdominal or pelvic position.Among themultifactorial etiologies proposed,laxity of the spleen’s primary supporting ligaments is themost agreed-upon hypothesis.We present one rare case of wandering spleen in an 11-year-old girl who presented with recurrent abdominal pain with no localizing features.Her abdominal examination revealed an intra-abdominal left iliac fossa lump with restrictedmobility,which was confirmed as a wandering spleen by abdominal sonography and contrast-enhanced computed tomography.Intraoperatively,an infarcted spleen was encountered with tortuous,elongated,torsional splenic pedicle and a single dense adhesive band with descending colon.Splenectomy was offered to the patient.Post-operatively,the patient is healthy and symptom free at one-year follow-up.The rare clinical diagnosis of this condition,particularly in the paediatric age-group,makes it an enigma for the surgical world.
