Nobre S, Salgado C
Hospital Pediitrico Carmona da Mota, Centro Hospitalar de Coimbra-EPE, 3000-602 Coimbra, Portugal.
Cir Pediatr. 2011 Apr;24(2):122-5.
An ectopic/wandering spleen is rare in children. It results from the absence or laxity of the supporting ligaments which may cause torsion of the splenic pedicle with subsequent infarction. We present a case of a six-year-old girl, with history of onphalocele, dextrocardia and ectopic spleen (incidentally discovered three years ago as an abdominal mass on physical examination), with acute abdominal pain and signs of peritoneal irritation. Sonography showed an enlarged ectopic spleen in the pelvis. Computed tomography scan did not enable visualization of the spleen and allowed the identification of a pelvic mass without uptake of intravenous contrast. Splenectomy was performed due to splenic infarction. In the presence of a wandering spleen, even if asymptomatic, splenopexy may be performed to minimize complications, and together with acute abdominal pain, torsion of splenic pedicle may be considered.
异位/游走脾在儿童中罕见。它是由于支持韧带缺失或松弛所致，这可能导致脾蒂扭转并继发梗死。我们报告一例6岁女孩，有脐膨出、右位心和异位脾病史（3年前体检时偶然发现腹部肿块），出现急性腹痛和腹膜刺激征。超声检查显示盆腔内有一个增大的异位脾。计算机断层扫描未能显示脾脏，却发现盆腔有一肿块，静脉造影剂未摄取。因脾梗死行脾切除术。对于游走脾，即使无症状，也可进行脾固定术以尽量减少并发症，若出现急性腹痛，则可能是脾蒂扭转。
