Bilobate wandering spleen with doble torsion of the vascular pedicle. A case report

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COD: 2653_08_03_2017_EP Categorie: , ,

Sossio Barra, Renata Lepore, Adele Cappabianca, Floriana Barra

Ann Ital Chir, Digital Edition 2017, 6
Epub, March 8

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INTRODUCTION: Wandering spleen is a rare clinical condition which is often an incidental finding. It is characterized
by excessive mobility and displacement of the spleen within the abdomen; although the spleen is usually of normal size
it has an elongated vascular pedicle .
CASE STUDY: We present the case of an adult woman who complaining of abdominal pain who was brought to our
institution for emergency treatment. She later developed an acute abdomen due to infarction of a wandering spleen caused
by double torsion of the vascular pedicle. Emergency splenectomy was performed.
RESULTS: Surgical treatment of a wandering spleen is generally conservative and consists in splenoplexy. In our case, complicated
by ischemia leading to irreversible damage of the spleen, splenectomy was the solution.
DISCUSSION: The long vascular pedicle of a migrant spleen is at risk of torsion which can cause irreversible acute ischemia
of the spleen. Therefore a timely diagnosis with the use of modern imaging techniques is of primary importance.
CONCLUSIONS: Early interpretation of the symptoms and computed tomography angiography can prevent the complications
that result from torsion of the elongated pedicle.

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