Rafie Basmah A, AbuHamdan Omar J, Trengganu Nawal S, Althebyani Badr H, Almatrafi Bassam S
Department of General Surgery, Hera General Hospital, Makkah 21955, Kingdom of Saudi Arabia.
Department of Radiology, Hera General Hospital, Makkah 21955, Kingdom of Saudi Arabia.
J Surg Case Rep. 2018 May 18;2018(5):rjy107. doi: 10.1093/jscr/rjy107. eCollection 2018 May.
A wandering spleen is a condition characterized by excessive splenic mobility due to the mal-development or the laxity of its ligaments that leads to migration from its normal anatomical location. This condition renders its long mobile vascular pedicle liable to torsion and occasional infarction. Herein, we report a case of a 27-year-old nulliparous woman who presented with acute abdominal pain and a tender right-sided pelvi-abdominal mass. CT scan of the abdomen and pelvis revealed a torted, infarcted wandering spleen with portal hypertension and mesenteric varices that mandated an emergency splenectomy. Although there are a few reported cases describing the association of wandering spleen with portal hypertension and fundal varices, cases of mesenteric varices are extremely rare. To the best of our knowledge, this case is considered the third reported case of a wandering spleen which was subsequently complicated by portal hypertension and mesenteric varices that was managed effectively with splenectomy.
游走脾是一种由于韧带发育不良或松弛导致脾脏活动度过大，从而使其从正常解剖位置移位的病症。这种情况使得其长而可移动的血管蒂易于扭转并偶尔发生梗死。在此，我们报告一例27岁未生育女性病例，该患者表现为急性腹痛和右侧盆腔腹部压痛性肿块。腹部和盆腔CT扫描显示一个扭转、梗死的游走脾，伴有门静脉高压和肠系膜静脉曲张，因此需要进行急诊脾切除术。尽管有少数报道描述了游走脾与门静脉高压和胃底静脉曲张的关联，但肠系膜静脉曲张的病例极为罕见。据我们所知，该病例被认为是第三例报道的游走脾病例，随后并发门静脉高压和肠系膜静脉曲张，并通过脾切除术得到有效治疗。
