Rellum Rashidi, Risseeuw Gerard, Blaauw Ivo de, Lequin Maarten
Department of Internal Medicine, Sint Franciscus Gasthuis, Rotterdam, The Netherlands.
Department of Radiology, Ruwaard van Putten Hospital, Spijkenisse, The Netherlands.
European J Pediatr Surg Rep. 2014 Jun;2(1):26-8. doi: 10.1055/s-0034-1370776. Epub 2014 Mar 28.
Wandering spleen is a rare cause of acute or chronic recurrent abdominal pain with a risk of splenic torsion and infarction. We describe a case of a 14-year-old girl with chronic recurrent abdominal pain with a palpable spleen in normal position on the initial physical examination. Laboratory findings were normal. A normal blood flow was seen on the initial (color Doppler) sonography. Magnetic resonance imaging showed an enlarged spleen in the pelvic region with torsion of hilar pedicle and splenorenal collaterals. Semielective, a laparoscopic splenopexy was performed without complications. A twisted wandering spleen should be included in the differential diagnosis of recurrent abdominal pain despite possible normal positioning of the spleen. The presence of splenorenal collaterals on imaging techniques can be used as a diagnostic hallmark.
游走脾是急性或慢性复发性腹痛的罕见病因，存在脾扭转和梗死风险。我们报告一例14岁女孩，有慢性复发性腹痛，初次体格检查时脾脏位置正常且可触及。实验室检查结果正常。初次（彩色多普勒）超声检查显示血流正常。磁共振成像显示盆腔区域脾脏增大，脾门蒂扭转及脾肾侧支循环形成。行半择期腹腔镜脾固定术，无并发症。尽管脾脏位置可能正常，但反复腹痛的鉴别诊断应包括扭转的游走脾。影像学检查中脾肾侧支循环的存在可作为诊断标志。
