Schrijver Willemijne A M E, Dijkstra Robert F, van der Werff Ytzen D
St. Antonius Ziekenhuis, Nieuwegein. Afd. Heelkunde.
Contact: Willemijne A.M.E. Schrijver (
Ned Tijdschr Geneeskd. 2021 May 19;165:D5318.
A wandering spleen is a relatively unknown condition, where the spleen may be enlarged and is located in an aberrant position in the abdomen. It is caused by abnormally constructed or absent ligaments that should keep the spleen in the correct position or an excessively long vascular stem. The pathophysiology is congenital or secondary to trauma, abdominal surgery, pregnancy or splenomegaly.
A 21-year-old woman was presented at the emergency department with acute abdominal pain in the left lower quadrant. A CT-scan of the abdomen showed splenomegaly, with the spleen showing reduced blood flow and a location in the lower abdomen. During an emergency laparoscopy, the spleen was found to be ischemic based on a torsion of the vascular pedicle. A splenectomy followed and the patient showed an uncomplicated recovery.
Splenopexy or splenectomy is the treatment of choice for a symptomatic wandering spleen.
游走脾是一种相对罕见的病症，脾脏可能肿大并位于腹部异常位置。它是由本应将脾脏固定在正确位置的韧带结构异常或缺失，或血管蒂过长引起的。其病理生理机制为先天性，或继发于创伤、腹部手术、妊娠或脾肿大。
一名21岁女性因左下腹急性腹痛就诊于急诊科。腹部CT扫描显示脾肿大，脾脏血流减少且位于下腹部。在急诊腹腔镜检查中，发现脾脏因血管蒂扭转而缺血。随后进行了脾切除术，患者恢复顺利。
对于有症状的游走脾，脾固定术或脾切除术是首选治疗方法。
