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Query: UMLS:C0000737 (abdominal pain)
 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Wandering spleen may result from congenital failure of splenic attachments or acquired laxity of attachments due to stretching. The wandering spleen is quite vulnerable to the complication of torsion, which is seen most often as an acute abdominal emergency due to splenic infarction. A more unusual variant is chronic torsion which causes intermittent mild to moderate abdominal pain, gastrointestinal disturbances and, in one case, hypersplenism. A mass has been present in most cases and may be anywhere in the abdomen or pelvis. Splenectomy should be performed for all cases of wandering spleen with or without torsion.
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PMID:Chronic torsion of the spleen. 93 48

Wandering spleen is uncommon and of difficult diagnosis. New Imaging Modalities (Eco; TC), can suggest or confirm the preoperative diagnosis of wandering spleen, permitting conservative surgery, mainly in children. We report two cases of wandering spleen. The first one, with acute surgical abdomen and tumor on left iliac fossa, operated as an ovarian cyst torsion: the laparotomy showed a necrotic spleen in pelvis. The second case presented as intestinal sub-occlusion with recurrent abdominal pain, and a left iliac fossa movable tumor. It was diagnosed by eco and radionuclides before laparotomy. Even diagnosed in different ways, the surgical treatment was the same.
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PMID:[Torsion of wandering spleen. An unusual case of abdominal pain]. 159 86

Wandering spleen is an uncommon diagnosis and has been rarely described in children. A review of the English literature yielded 35 reported cases in children less than 10 years of age. Eighteen (51%) presented as acute surgical emergencies, only eight of which had the correct diagnosis of pedicle torsion with splenic infarction established preoperatively. Thirteen patients underwent an elective laparotomy, either for chronic symptoms related to their wandering spleen or for an abdominal mass. Of the 13 patients electively managed, nine underwent a splenectomy while five were treated successfully with splenopexy. The remaining four patients were managed conservatively without surgical intervention. In only one third of the patients presenting as acute surgical emergencies was there any history of intermittent abdominal pain or of a previous abdominal mass. No deaths were reported. Males represented 63% of the patients. The occurrence was most common in patients less than 1 year of age, with a 6:1 male predominance in this age category. All acute cases of wandering spleen in which splenic infarction has occurred require splenectomy. However, in patients with chronic symptoms or in whom the diagnosis is made prior to splenic infarction, splenopexy should be the treatment of choice. Past recommendations of splenectomy or conservative nonsurgical management are not indicated. Literature on pediatric wandering spleen is reviewed herein, and a technique for splenopexy using Dexon mesh is described.
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PMID:Pediatric wandering spleen--the case for splenopexy: review of 35 reported cases in the literature. 266 92

Wandering spleen is a rare entity which may present with symptoms suggestive of other, more common abdominal processes. Torsion of the long pedicle may occur causing abdominal pain. This article describes a case of wandering spleen diagnosed by computed tomography (CT). Liver spleen scintigraphy and sonography supported this diagnosis and suggested torsion. To our knowledge this is only the second case of this entity in which color flow and duplex Doppler findings have been reported.
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PMID:Wandering spleen with torsion: appearance on CT and ultrasound. 795 Aug 28

Wandering spleen is a clinical condition in which an absence of ligaments and a long vascular pedicle allows the spleen to move freely in the abdomen. It is a rare entity in children but the exactly incidence is unknown because most of them are asymptomatic. The most common form of presentation is acute, chronic or intermittent abdominal pain caused by spleen torsion. Ultrasonography is the elective diagnostic method, but frequently diagnosis is made after surgery. We report two cases with acute splenic torsion in children and we discuss the clinical presentation, etiology, diagnostic procedures and management. We conclude that splenopexy--if possible--is the treatment of choice in children.
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PMID:[Wandering spleen syndrome in childhood]. 914 71

Wandering spleen is a rare cause of abdominal pain in children, and an accurate diagnosis is seldom made preoperatively. A splenectomy is the treatment of choice in cases of splenic torsion and infarction, while in patients with chronic symptoms splenopexy may also be attempted. We herein report three patients with wandering spleen, of whom two presented with acute torsion of the splenic pedicle and one demonstrated an asymptomatic mobile abdominal mass. In the first case splenopexy was attempted, but during follow-up the spleen was found to have undergone atrophy. The presentation, diagnostic procedures, and treatment modalities in pediatric wandering spleen are reviewed.
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PMID:Wandering spleen in childhood: a report of three cases. 941 67

Wandering spleen is seldom seen in everyday situations, and its prevalence is not well defined in the literature. Its causes are not precisely known, and there is controversy over its management. A 34-year-old woman experienced low-intensity abdominal pain associated with a palpable hypogastric mass, which was confirmed by imaging studies to be a wandering spleen. Because of ureteral compression, a surgical approach was decided upon, and videolaparoscopic splenectomy was chosen. This technique, comments about specific technical issues, and other treatment options presented in the literature are discussed. Videolaparoscopic splenectomy has excellent surgical results, both functional and aesthetic.
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PMID:Laparoscopic approach to wandering spleen: a case report and an update to the question. 979 46

Wandering spleen is an uncommon condition, showing a splenic hypermobility that results from laxity or maldevelopment of its suspensory ligament. This condition results in constant danger of splenic torsion and infarction. Wandering spleen was diagnosed in a 2-year-old girl who complained of intermittent abdominal pain, and viability of the spleen was confirmed by doppler ultrasound scan. Elective laparoscopic splenopexy was performed by anchoring the spleen wrapped in absorbable mesh. To our knowledge, this is the first reported case of laparoscopic splenopexy for wandering spleen. The authors believe that this approach is a safe and effective procedure for wandering spleen with the advantage of minimally invasive surgery.
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PMID:Laparoscopic splenopexy for pediatric wandering spleen. 980 19

Wandering spleen is an unusual entity and remains an elusive clinical diagnosis. Among the modern imaging modalities including computed tomography, magnetic resonance imaging, nuclear scans and ultrasonography, the latter appears to be the least invasive and the most effective in reaching a definitive diagnosis. A patient with 'true' wandering spleen who presented with chronic, intermittent abdominal pain, weight loss and a right lower quadrant mass that was interpreted as a pelvic lymphoma or a primary pelvic malignancy on computed abdominal tomography (CAT) scan is presented. Abdominal ultrasonography conducted a few weeks before the CAT scan showed a normal splenic shadow in the left upper abdomen.
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PMID:The 'true' splenic wanderer. 1020 39

Wandering spleen is an extremely rare anatomic variant with potentially serious clinical implications. Usually, splenectomy is advocated for treatment of this disease. Various methods for preserving the wandering spleen by means of splenopexy have been described, including two reports on laparoscopic splenic refixation. We describe the third case in which laparoscopic splenopexy was used to manage chronic intermittent splenic torsion. In a 25-year-old woman, splenopexy was successfully performed by laparoscopic reposition and fixation of the spleen by omental pouch creation. At laparoscopy with a normal operating room setup and four trocars, a free-floating, macroscopically normal spleen attached to an abnormally long vascular pedicle with no gastrosplenic or phrenicosplenic ligaments was detected in the lower right quadrant. The spleen was repositioned and placed in the left phrenorenal angle. Splenopexy was achieved by suturing the left colophrenic ligament to the lateral diaphragm, thus creating a pouch for the inferior part of the spleen, and by suturing the gastrocolic ligament to the anterior diaphragm to create a pouch for the upper splenic pole. The postoperative course was uneventful. At a follow-up examination 3 months after the operation, the patient was well, with no further episode of recurrent abdominal pain. Ultrasonographically, the spleen was seen easily in the left hypochondrium in its normal physiologic position. Laparoscopic splenopexy is a useful option for organ-preserving therapy of the wandering spleen.
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PMID:Laparoscopic splenopexy by peritoneal and omental pouch construction for intermittent splenic torsion ("wandering spleen"). 1139 27


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