[Ultrasonic manifestations of splenic torsion in children]

The ultrasonic image data of children who underwent abdominal ultrasound examination in Tianjin Children's Hospital from January 2018 to December 2024 and were confirmed by surgery and pathology were retrospectively analyzed, and their ultrasonic manifestations were summarized. A total of 6 children, 1 male and 5 female, were included. At the time of first diagnosis, the children were 1-14 years old with a median age of 9 years. Ultrasound showed that the twisted spleen was enlarged, with 5 cases showing abnormal spleen position and 1 case showing in-situ splenic torsion. Taking the echo of the liver as a reference, the internal echo of 4 cases showed diffuse echo enhancement and roughness, and the internal echo of 2 cases was alternating with high and low echo, with extremely low echo liquefaction area; In 6 cases, the structure of splenic pedicle at the hilum of spleen was disordered and thickened, with enhanced echoes, of which 2 cases showed vortex sign by dynamic observation; The echo of tissues around the spleen was enhanced in 6 cases and here was perisplenic effusion in 2 cases. Color Doppler flow imaging indicated that there was no blood flow signal or sparse blood flow signal in spleen parenchyma and splenic hilum. Splenectomy was performed in 6 children, and splenic torsion and infarction were confirmed by postoperative pathology. Ultrasonographic manifestations of splenic torsion in children are multiple abnormal positions of spleen; The internal echo is thickened and enhanced, and some extremely low echo liquefaction areas can be seen; The spleen pedicle is thickened and the echo is enhanced, and some of them show vortex sign; The echo of the tissue around the spleen is enhanced.