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• W2429421378 abstract "A 7.5 year old otherwise healthy boy was transferred from another hospital, with abdominal pain, an increase of his abdominal girth and a decrease in hemoglobin level observed over a 2 day period. Physical examination revealed splenomegaly and tenderness in the left lower quadrant with slight rebound. The white blood cell count was elevated (20,000/mm). Ultrasonography demonstrated no blood flow in the splenic vein and a low flow in the splenic artery. Subsequent computerized tomography showed an enlarged spleen, situated in the left mid-abdomen caudal to its normal position [Figure A, B]. There was no parenchymal enhancement after intravenous contrast administration. A whorled appearance typical of torsion of the splenic pedicle was seen medial and cranial to the spleen [Figure B]. At urgent laparotomy an enlarged infarcted spleen with torsion of its pedicle were found and splenectomy was performed. The boy had an uneventful recovery. Acute, chronic or intermittent torsion of the spleen is the major complication of an abnormally mobile spleen, the spleen. The increased mobility of the spleen results from absence or laxity of the supporting ligaments (gastrosplenic and splenorenal ligaments) that normally anchor the spleen in its normal position. This anomaly is quite rare, with a reported incidence of less than 0.5% in several large series of splenectomies. It has been reported to be found mainly in children [1] and in women aged 20±40 years [2]. The wandering spleen may be incidentally detected as an abdominal or pelvic mass. CT findings of a wandering spleen include absence of the spleen in its normal position and its location somewhere else in the abdomen or pelvis. Symptoms and signs of splenic torsion are quite variable: chronic abdominal discomfort probably due to splenic congestion or pressure from ligaments, intermittent pain presumably due to spontaneous torsion and detorsion, and less often severe abdominal pain from acute torsion and infarction, which produce marked congestion and capsular stretching [1±3]. Physical examination may reveal a tender mass [1]. The diagnosis of a torsioned spleen is usually not considered prior to imaging evaluation. The appearance of torsion on CT has characteristic features: a) the spleen is located in an abnormal position, in the mid-abdomen or pelvis, and" @default.
• W2429421378 created "2016-06-24" @default.
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• W2429421378 date "2002-08-01" @default.
• W2429421378 modified "2023-10-18" @default.
• W2429421378 title "Torsion of a wandering spleen." @default.
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