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| IMAGE IN HEMATOLOGY |
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| Year : 2014 | Volume
: 5
| Issue : 4 | Page : 168 |
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Wandering (ectopic) spleen
Hazza Alzahrani, N Chaudary, Rana AlQahtani
Department of Hematology and Bone Marrow Transplantation Section, Oncology Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| Date of Web Publication | 13-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
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/1658-5127.146954
How to cite this article:
Alzahrani H, Chaudary N, AlQahtani R. Wandering (ectopic) spleen. J Appl Hematol 2014;5:168 |
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 | |  |
| 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.  |
| 2. | Sharma A, Salerno G. A torted wandering spleen: A case report. J Med Case Rep 2014;8:133. |
| 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. [ PUBMED]  |
[Figure 1]
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