Splenic volvulus of a wandering spleen. Am J Emerg Med 2021 Mar;41:265.e1-265.e3
Date
10/13/2020Pubmed ID
33041134DOI
10.1016/j.ajem.2020.08.048Scopus ID
2-s2.0-85092240773 (requires institutional sign-in at Scopus site) 4 CitationsAbstract
BACKGROUND: Wandering spleen is a rare condition in which the spleen is not anchored properly, due to congenital or acquired weakness of the splenic ligaments. This allows the spleen to migrate to any portion of the abdomen or pelvis, and can cause complications, including a splenic volvulus. The presentation of splenic volvulus of a wandering spleen ranges from mild pain to a surgical emergency. Splenic volvulus of a wandering spleen can cause significant morbidity and mortality, and often warrants surgical intervention. Cases of splenic volvulus of a wandering spleen have been reported in radiology and surgery literature, however there are no reports in emergency medicine literature in North America.
CASE REPORT: A 37-year-old female presented to the ED with seven days of mild left upper quadrant abdominal pain that acutely worsened. She underwent laboratory studies which were near her baseline values. A CT abdomen pelvis demonstrated findings consistent with splenic volvulus of a wandering spleen. She was taken emergently to the operating room for exploratory laparotomy, detorsion of spleen, and splenectomy. Her postoperative course was uneventful and she was discharged on hospital day six. Splenic volvulus of a wandering spleen is rare, though carries significant morbidity and mortality, especially if unrecognized. The presentation of splenic volvulus is variable, ranging from minor symptoms to an acute abdomen. Early diagnosis can prevent downstream complications, including development of vascular congestion, ischemia or infarcted intra-abdominal organs. Emergency Physicians should consider splenic volvulus in the differential diagnosis as an etiology of left-sided abdominal pain.
Author List
Schaeffer WJ, Mahmood SMJ, Vermillion SA, Sweet R, Haas NLAuthor
William J. Schaeffer DO Assistant Professor in the Emergency Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultFemale
Humans
Splenic Diseases
Wandering Spleen
