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IMAGE IN HEMATOLOGY
Year : 2014  |  Volume : 5  |  Issue : 4  |  Page : 168

Wandering (ectopic) spleen


Department of Hematology and Bone Marrow Transplantation Section, Oncology Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia

Date of Web Publication13-Dec-2014

Correspondence Address:
Dr. Hazza Alzahrani
Department of Hematology and Bone Marrow Transplantation Section, Oncology Center, King Faisal Specialist Hospital and Research Center, Riyadh
Saudi Arabia
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1658-5127.146954

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How to cite this article:
Alzahrani H, Chaudary N, AlQahtani R. Wandering (ectopic) spleen. J Appl Hematol 2014;5:168

How to cite this URL:
Alzahrani H, Chaudary N, AlQahtani R. Wandering (ectopic) spleen. J Appl Hematol [serial online] 2014 [cited 2019 May 22];5:168. Available from: http://www.jahjournal.org/text.asp?2014/5/4/168/146954

A previously healthy 18-year-old woman was referred from a local hospital with a 2-week history of moderately severe mid abdominal pain along with episodes of nausea and vomiting. No hematemesis, melena or rectal bleeding was noted. The pain severity decreased to moderately dull on later follow-up.

Examination was unremarkable except for an ill-defined mildly tender epigastric mass.

Laboratory results revealed that white blood cell 8.6 × 10 9 /L, hemoglobin 100 g/L, platelets 786 × 10 9 /L. Renal and liver function tests were normal. Computed tomography abdomen revealed the mass to be a splenic torsion and displaced completely away from the splenic bed. Magnetic resonance angiography confirmed splenic torsion with complete splenic infarction.

She was planned for elective splenectomy.

Wandering (ectopic) spleen occurs due to laxity or absence of the normal intraperitoneal ligaments (gastro-splenic and splenorenal ligaments) that hold the spleen in its normal position in the left hypochondrium. It is a rare clinical occurrence with fewer than 500 cases reported and the incidence of <0.2%. Clinical manifestations of ectopic spleen vary from asymptomatic incidental finding to abdominal emergency. Complication rate (commonly attributed to torsion) occurs in 65% of the cases. It can be a diagnostic challenge with high mortality if mis-diagnosed. The treatment of choice is either splenopexy or splenectomy [Figure 1]. [1],[2],[3]
Figure 1: Abdominal Images of the spleen that is malpositioned to the central abdominal region instead of left hypochondrial location

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  References Top

1.
Blouhos K, Boulas KA, Salpigktidis I, Barettas N, Hatzigeorgiadis A. Ectopic spleen: An easily identifiable but commonly undiagnosed entity until manifestation of complications. Int J Surg Case Rep 2014;5:451-4.  Back to cited text no. 1
    
2.
Sharma A, Salerno G. A torted wandering spleen: A case report. J Med Case Rep 2014;8:133.  Back to cited text no. 2
    
3.
Gorsi U, Bhatia A, Gupta R, Bharathi S, Khandelwal N. Pancreatic volvulus with wandering spleen and gastric volvulus: An unusual triad for acute abdomen in a surgical emergency. Saudi J Gastroenterol 2014;20:195-8.  Back to cited text no. 3
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