Ahmadi Hamid, Tehrani Mahdieh Mohammad Khan
Department of General Surgery, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Acta Med Iran. 2016 Jan;54(1):72-5.
Wandering spleen is an uncommon entity in adults and has been described only rarely with sigmoid volvulus, that rarely affects children and adolescents. It is usually described in adults.Wandering spleen characterized by the abnormal location of the spleen, caused by incomplete fusion of the four primary splenic ligaments, allowing the spleen to be mobile within the abdomen.The wandering spleen can lead to torsion and subsequent splenic infarction or rupture. Clinical suspicion plus urgent investigation and intervention are important. We present a rare clinical case of acute abdomen due to torsion of wandering spleen and volvulus of sigmoid in a 14-year-old girl presented with painful periumbilical mass. Detorsion of sigmoid occurred while undergoing exploratory laparotomy and splenectomy was performed. The possibility of torsion and its complication like gastric, pancreas tail and colon volvulus should be kept in mind in the differential diagnosis of the acute abdomen to avoid serious complications.
游走脾在成人中是一种罕见的情况,仅有少数关于其合并乙状结肠扭转的报道,而乙状结肠扭转很少影响儿童和青少年,通常见于成人。游走脾的特征是脾脏位置异常,由四条主要脾韧带不完全融合所致,使得脾脏在腹腔内可移动。游走脾可导致扭转,继而引起脾梗死或破裂。临床怀疑加上紧急检查和干预很重要。我们报告一例罕见的临床病例,一名14岁女孩因游走脾扭转和乙状结肠扭转导致急腹症,表现为脐周疼痛性肿块。在进行剖腹探查时乙状结肠扭转复位,并实施了脾切除术。在急腹症的鉴别诊断中应考虑到扭转及其并发症如胃、胰尾和结肠扭转的可能性,以避免严重并发症。