Torsion of the wandering spleen as an abdominal emergency: a case report

Background Wandering spleen is a rare clinical entity with a less than 0.2% reporting incidence rate. In this case, the spleen is present abnormally in the abdominal or pelvic cavity instead of its normal anatomical location. The aetiology is either congenital or acquired. The condition is caused by the absence or maldevelopment of the spleen's suspensory ligaments, which holds the spleen static in the left hypochondrium. Case presentation A 27-year-old female patient presented to the emergency department with complaints of abdominal pain, fever, nausea, vomiting, and constipation for three days. A palpable movable mass was found during the physical examination, and torsion of the wandering spleen’s pedicle was confirmed by CT scan. Open splenectomy was performed, and the patient was recovered uneventfully. Conclusion Even though ectopic spleen is a rare disease, clinicians should be aware of its incidence. Early diagnosis in the case of an acute abdomen is vital for the preservation of the spleen. Patients presented with acute abdomen and absence of splenic shadow under left hemidiaphragm should be suspected, and further radiological investigation will confirm the diagnosis. Surgery is the gold standard for wandering spleen with either splenopexy or splenectomy, depending on the spleen's condition during surgery.

Torsion of the Vascular Pedicle of A Wandering Spleen: An Unusual Cause of Intestinal Strangulation

Ectopic spleen is a rare splenic malformation. Apart from torsion of the vascular pedicle, a common complication, an ectopic spleen could be responsible of an acute intestinal obstruction. We report a case of an 8-year-old girl who presented an acute abdomen, following of the transverse colon strangulation by the torsion of the vascular pedicle of a wandering spleen. The patients benefited a surgical opening into the abdomen who has been confirmed the diagnosis and made a detorsion of the vascular pedicle of spleen with splenopexy.The interest of this case report lies on the rarity of a wandering spleen and on the unusual situation of transverse colon strangulation by the vascular pedicle of spleen.

Abdominopelvic ectopic spleen with a comprehensive imaging examination: a case report

Ectopic spleen is a rare clinical malformation in which the spleen is relocated from its normal anatomical position to other parts of the abdomen. We report a rare case of abdominopelvic ectopic spleen caused by splenic ligament deficiency. A patient experienced intermittent pain in the left upper abdomen that was progressively aggravated. This was confirmed by comprehensive imaging examinations and postoperative pathology. We also performed a review of the literature on the current state of the field. Our data may help to improve the diagnosis and treatment of ectopic spleen.

Ectopic spleen presenting as a slowly enlarging lung nodule in the right lower lobe following gastric pull up operation

This is a case report of an elderly man who was investigated at our respiratory clinic for slowly enlarging right lower lobe lung nodule on the background of oesophageal cancer diagnosed more than 11 years ago with gastric pull up. CT guided biopsy confirms the diagnosis of intrathoracic ectopic spleen.

The ectopic spleen-incidental finding on pelvic magnetic resonance imaging

The ectopic spleen (ES) is a rare variation occurred depend on the absence or laxity of the suspensory ligaments. The ES is a rarely diagnosed clinical condition. Less than 500 symptomatic patients have been reported. Less than 0.25% of splenectomies are performed on the ES. Patients are usually asymptomatic. It's diagnosed incidentally in general. The incidence is not clear. ES incidence is reported less than 0.5%. However, this rate covers all of the relocations. The spleen can be found anywhere in the abdomen or pelvis, depends on the length of the vascular pedicle. The pelvic ES is a rarely encountered situation. Knowing this anomaly is essential for early diagnosis and prevention serious problems such as torsion, infarction and acute abdomen. A 21 years old female patient with ES was presented on pelvic magnetic resonance imaging.

Endoscopic full-thickness resection of gastric ectopic splenic nodules

Background Ectopic spleen is extremely rare. Most cases are congenital, acquired ectopic spleen may be a consequence of surgery or trauma to the spleen. The ectopic spleen in the gastric wall we reported is even rarer. Case presentation We report a 41-year-old female patient, with a past history of splenectomy, who presented with heartburn. Gastroscopy revealed a swelling in the fundus in the stomach. Ultrasonography and computed tomographic examination suggested the possibility of gastrointestinal stromal tumor. We performed endoscopic resection of the mass. Pathological examination of the resected mass showed ectopic spleen. Conclusion When a patient with a history of splenectomy presents with a gastric submucosal tumor, ectopic spleen should also be considered in the differential diagnoses. And minimally invasive endoscopic treatment can achieve the purpose of diagnosis and treatment for unobvious submucosal tumors.

Pancreatic nodule positive for 68-Ga-DOTAPEPTIDE-PET: NET or ectopic spleen? The importance of a good differential diagnosis

Background Accessory spleen is a congenital defect in which splenic tissue is present outside the spleen. In 20% of cases, accessory spleen is localized within the pancreatic tail, a condition known as IPAS. The identification of this benign anomaly, which affects about 2% of general population, is not easy because it is often mistaken for a pNET which is more common, at around 5%. A 68-Ga-DOTAPEPTIDE-PET normally identifies pNETs with high rate of sensitivity and specificity, but in some conditions, it produces false positives, including IPAS. Materials and tools A clinical case we recently encountered, prompted us to review the available medical literature on the topic. Typing “intrapancreatic accessory spleen” into PubMed database and limiting research to the last 10 years yielded 121 results from which we selected the most relevant articles for decision-making, with a brief explanation of the reasons for selecting those. Our analysis focused on the most critical and least descriptive articles, those which clearly indicated the importance of differential diagnosis by promoting the use of advanced investigations in case of pancreatic nodule suspected for IPAS. Ultimately, our objective was to update the available guidelines recommendations. Discussion and conclusions Despite concern in the medical literature, a differential IPAS diagnosis is still subordinate to other clinical, radiological, nuclear medicine, and cytological criteria. After reviewing the literature, we recommend that IPAS should always be considered as a possibility before diagnosis of pNET is made. IPAS should be suspected in the presence of the following findings: asymptomatic pancreatic nodule found incidentally, absence of laboratory findings of NETs, localization in the pancreatic tail, between 1 and 3 cm in size with well-defined margins, homogeneous enhancement, and similar attenuation to the spleen on CT and MRI. In these cases, the use of advanced investigations beyond 68-Ga-DOTAPEPTIDE-PET must be systematic. The recognition of IPAS is not only a diagnostic refinement, but it also avoids unnecessary surgery for the patient.

Acute abdomen due to an infarction of wandering spleen: case report

Wandering spleen is a rare condition characterized by the absence or underdevelopment of one or all spleen ligaments that fixate the spleen in the left upper quadrant. Many different terms refer to wandering spleen like dislocated spleen, ectopic spleen and displaced spleen. We report in this case a 13-year-old Syrian girl presented to the emergency department complaining of acute generalized abdominal pain with fever, anorexia and vomiting started 2 days prior to presentation. A splenectomy was performed, with uneventful postsurgical follow-up. Wandering spleen is prone to torsion and infarction resulting in acute abdomen and a life-threatening condition with high mortality rate reaching 50%. We advise the investigation of any recurrent episodes of chronic pain keeping up within mind this diagnosis.