Olasehinde O, Aderibigbe A S, Akinkuolie A A, Adisa A O, Ajenifuja K O, Aladesuru O A, Oyekunle O
Afr J Med Med Sci. 2014 Mar;43(1):75-8.
Wandering spleen is an uncommon entity that is rarely considered in the evaluation of patients with acute abdominal conditions.
To report two cases of wandering spleen presenting with acute abdominal pain.
The clinical records of the patients including preoperative evaluation, intra-operative findings and postoperative care were reviewed
A 6 year old boy presented with right lumbar pain which worsened over a 36 hour period with findings of a tender right lumbar mass. Abdominal ultrasound showed a mass with echogenicity consistent with that of the spleen with no blood flow and an empty splenic bed. The pre-operative diagnosis was torsion of a wandering spleen. The second case was that of a 42 year old woman who presented with severe colicky lower abdominal pain which worsened over three days with a background history of progressively increasing lower abdominal mass which was tender and about 26 week gestational size at presentation. The initial diagnosis was torsion of an ovarian cyst. Abdomino-pelvic Ultrasound scan showed a heterogeneously hypo-echoic mass overlying the uterus and the left ovary with no blood flow. The presence of wandering spleen with torsion of the vascular pedicle was confirmed at laparotomy in both instances. Splenectomy was performed in both cases with good recovery.
Torsion of a wandering spleen poses a diagnostic challenge. A high level of suspicion is required to make a diagnosis and institute appropriate treatment.
游走脾是一种罕见的病症，在评估急性腹部疾病患者时很少被考虑到。
报告两例以急性腹痛为表现的游走脾病例。
回顾患者的临床记录，包括术前评估、术中发现及术后护理情况。
一名6岁男孩出现右腰部疼痛，在36小时内加重，检查发现右腰部有压痛性肿块。腹部超声显示一个肿块，其回声与脾脏一致，无血流信号，脾床空虚。术前诊断为游走脾扭转。第二例是一名42岁女性，出现严重的下腹部绞痛，三天内加重，有下腹部肿块逐渐增大的病史，就诊时肿块有压痛，大小约为妊娠26周。初步诊断为卵巢囊肿扭转。腹部盆腔超声扫描显示子宫和左卵巢上方有一个不均匀低回声肿块，无血流信号。两例患者均在剖腹手术中证实存在游走脾伴血管蒂扭转。两例均行脾切除术，恢复良好。
游走脾扭转带来诊断挑战。需要高度怀疑才能做出诊断并进行适当治疗。
