Department of General Surgery, Amiri Medical Complex, Qargha Road, Afshar, Kabul, Afghanistan.
Department of Cardiovascular Surgery, The Second Xiangya Hospital of Central South University, 139 Renmin Middle Rd, Changsha, 410011, China.
BMC Surg. 2021 Jun 9;21(1):289. doi: 10.1186/s12893-021-01289-x.
Wandering spleen is a rare clinical entity with a less than 0.2% reporting incidence rate. In this case, the spleen is present abnormally in the abdominal or pelvic cavity instead of its normal anatomical location. The aetiology is either congenital or acquired. The condition is caused by the absence or maldevelopment of the spleen's suspensory ligaments, which holds the spleen static in the left hypochondrium.
A 27-year-old female patient presented to the emergency department with complaints of abdominal pain, fever, nausea, vomiting, and constipation for three days. A palpable movable mass was found during the physical examination, and torsion of the wandering spleen's pedicle was confirmed by CT scan. Open splenectomy was performed, and the patient was recovered uneventfully.
Even though ectopic spleen is a rare disease, clinicians should be aware of its incidence. Early diagnosis in the case of an acute abdomen is vital for the preservation of the spleen. Patients presented with acute abdomen and absence of splenic shadow under left hemidiaphragm should be suspected, and further radiological investigation will confirm the diagnosis. Surgery is the gold standard for wandering spleen with either splenopexy or splenectomy, depending on the spleen's condition during surgery.
游走脾是一种罕见的临床病症，其发病率低于 0.2%。在这种情况下，脾脏位于腹腔或盆腔内，而不是其正常的解剖位置。病因既有先天性的，也有后天获得性的。这种情况是由于脾脏的悬韧带缺失或发育不良引起的，悬韧带将脾脏固定在左季肋部。
一名 27 岁女性患者因腹痛、发热、恶心、呕吐和便秘 3 天就诊于急诊科。体格检查时发现可触及移动性肿块，CT 扫描证实为游走脾蒂扭转。行开放性脾切除术，患者术后恢复顺利。
尽管异位脾是一种罕见疾病，但临床医生应该了解其发病率。对于急性腹痛，早期诊断对于脾脏的保留至关重要。对于出现急性腹痛且左膈肌下未见脾脏阴影的患者，应怀疑为游走脾，并进一步进行影像学检查以明确诊断。手术是游走脾的金标准，根据术中脾脏的情况，可以选择脾固定术或脾切除术。
