Pelvic spleen with uterovaginal prolapse

Area of Science:

• Gastroenterology and Gynecology
• Surgical Case Report

Background:

• Wandering spleen (pelvic spleen) is a rare condition where the spleen is not in its normal anatomical position.
• Uterovaginal prolapse is the descent of the uterus and vagina into or beyond the vaginal canal.
• Ascariasis is a parasitic worm infection affecting the intestinal and biliary tracts.

Observation:

• A patient presented with symptoms indicative of pelvic mass and lower abdominal discomfort.
• Pelvic examination revealed severe uterovaginal prolapse.
• Intraoperative findings during laparotomy identified a congested, enlarged spleen within the pelvic cavity.

Findings:

• The patient was diagnosed with a wandering spleen, third-degree uterovaginal prolapse, and concurrent ascariasis of the biliary and intestinal tracts.
• Congested splenomegaly was confirmed in the pelvic region during exploratory laparotomy.
• Surgical management involved splenectomy, total abdominal hysterectomy, and bilateral salpingo-oophorectomy.

Implications:

• This case highlights the rare co-occurrence of wandering spleen, severe pelvic organ prolapse, and parasitic infestation.
• It underscores the importance of comprehensive diagnostic evaluation in complex presentations involving multiple organ systems.
• The successful surgical management demonstrates the feasibility of addressing these concurrent conditions through laparotomy.