Carmona Jorge, Lugo Vicente Humberto
Department of Surgery, UPR School of Medicine, Puerto Rico Health Science Center, Rio Piedras, Puerto Rico.
Bol Asoc Med P R. 2010 Apr-Jun;102(2):47-9.
Wandering spleen is a rare birth defect characterized by absence or weakness of one or more of the ligaments that hold the spleen in its normal position. In this report we present the case of a 6-year-old girl admitted with diffuse abdominal pain, fever and emesis. Ultrasound and CT scan revealed the spleen was not found in its normal anatomical position. An enlarged spleen was identified displaced anteriorly and inferiorly at the L3 to L5-S1 level. Doppler ultrasonography of the splenic vessels revealed no blood flow consistent with infarction. Patient was taken to the operation room for a laparoscopic splenectomy. Treatment of choice for splenoptosis is surgery, either splenopexy or splenectomy. Decision to perform splenopexy or splenectomy depends on the viability of the spleen after detorsion. If the spleen appears infarcted, a splenectomy should be performed. Splenopexy is a reasonable option when the spleen appears viable after detorsion.
游走脾是一种罕见的先天性缺陷，其特征是固定脾脏于正常位置的一条或多条韧带缺失或薄弱。在本报告中，我们呈现了一名6岁女孩的病例，她因弥漫性腹痛、发热和呕吐入院。超声和CT扫描显示脾脏不在其正常解剖位置。发现一个肿大的脾脏向前下方移位至L3至L5-S1水平。脾脏血管的多普勒超声检查显示无血流，符合梗死表现。患者被送往手术室进行腹腔镜脾切除术。脾下垂的治疗选择是手术，即脾固定术或脾切除术。决定进行脾固定术还是脾切除术取决于扭转后脾脏的活力。如果脾脏看起来已梗死，则应进行脾切除术。当扭转后脾脏看起来有活力时，脾固定术是一个合理的选择。
