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The 'true' splenic wanderer.

R Kanthan1, J M Radhi

  • 1University of Saskatchewan, Saskatoon, Canada.

Canadian Journal of Gastroenterology = Journal Canadien De Gastroenterologie
|April 15, 1999
PubMed
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Wandering spleen is a rare condition that can be difficult to diagnose. Ultrasonography is the most effective and least invasive imaging method for identifying this splenic anomaly.

Area of Science:

  • Radiology
  • Gastroenterology
  • Pediatric Surgery

Background:

  • Wandering spleen is a rare congenital anomaly characterized by the spleen's abnormal migration from its normal position in the left upper quadrant.
  • It lacks normal peritoneal or splenocolic ligamentous support, leading to a long and potentially vascular pedicle.
  • This anatomical variation predisposes the spleen to torsion, infarction, and other complications, often presenting with vague abdominal symptoms.

Observation:

  • A case of 'true' wandering spleen is presented in a patient experiencing chronic, intermittent abdominal pain and weight loss.
  • Computed abdominal tomography (CAT) scan suggested a pelvic mass, misinterpreting the wandering spleen's location.
  • Previous abdominal ultrasonography had shown a normal splenic shadow in the typical left upper quadrant location.

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Findings:

  • Ultrasonography is highlighted as the least invasive and most effective imaging modality for diagnosing wandering spleen.
  • The study emphasizes the diagnostic challenge posed by wandering spleen, which can mimic other abdominal pathologies like lymphoma or malignancy.
  • The discrepancy between CAT scan findings and prior ultrasonography underscores the importance of considering rare diagnoses and utilizing appropriate imaging techniques.

Implications:

  • Accurate and timely diagnosis of wandering spleen is crucial to prevent splenic complications such as torsion and infarction.
  • Ultrasonography should be considered a primary diagnostic tool for suspected wandering spleen, especially when initial imaging is equivocal.
  • This case highlights the need for a high index of suspicion for rare conditions in patients with atypical abdominal presentations.