The enigmatic wandering spleen: managing three cases in a tertiary setting

Area of Science:

• Pediatric Surgery
• Abdominal Imaging
• Clinical Case Reports

Background:

• Wandering spleen is a rare condition with abnormal splenic mobility due to ligament laxity.
• In children, it can cause vague symptoms or acute torsion, leading to splenic infarction and diagnostic challenges.
• Early diagnosis and intervention are vital for preserving spleen function.

Purpose of the Study:

• To report three pediatric cases of wandering spleen with diverse clinical presentations.
• To illustrate different surgical management strategies for this rare condition.
• To emphasize the importance of splenic salvage for maintaining immunologic function.

Main Methods:

• Retrospective analysis of three pediatric cases managed in a tertiary care setting.
• Review of clinical presentations, diagnostic imaging findings, and surgical interventions.
• Evaluation of outcomes focusing on splenic viability and function preservation.

Main Results:

• Case 1: 13-year-old girl with abdominal pain, requiring splenectomy after failed detorsion.
• Case 2: 10-year-old girl with known pelvic spleen, underwent successful splenopexy.
• Case 3: 3-year-old girl with fever and pain, splenic tissue salvaged via detorsion and splenopexy.

Conclusions:

• Wandering spleen exhibits variable presentations in children, necessitating accurate imaging for diagnosis.
• Splenic salvage (splenopexy) is preferred for viable spleens to maintain immunologic function.
• Splenectomy is reserved for nonviable spleens, with essential post-operative monitoring for complications.