Elnour Abdelrahman S, Yagoub Adam, Saeed Ahmed, Nugud Faisal, Alshaikh Ahmed A
National Centre for Pediatric Surgery, Sudan.
Federal Ministry of Health, Sudan.
Int J Surg Case Rep. 2025 Jun;131:111391. doi: 10.1016/j.ijscr.2025.111391. Epub 2025 Apr 28.
Wandering spleen is a rare condition characterized by abnormal spleen mobility due to defects in its supporting ligaments. Delayed management can lead to severe complications such as torsion and infarction, making early diagnosis and surgical intervention crucial for preventing adverse outcomes.
A 16-year-old girl presented with recurrent episodes of severe left hypochondrial pain, which worsened over six months, accompanied by occasional vomiting. Physical examination revealed a tender, palpable spleen extending from the left hypochondrium to the left iliac fossa. Imaging studies, including abdominal ultrasound and contrast-enhanced CT scan, revealed an enlarged spleen with signs of pedicle torsion and infarction, confirming a diagnosis of wandering spleen with vascular compromise. An emergency splenectomy was performed, revealing significant splenic enlargement with torsion and infarction, with no ligamentous attachments. The patient recovered uneventfully and received a pneumococcal vaccine along with long-term antibiotic prophylaxis prior to discharge.
Wandering spleen often presents with nonspecific symptoms, leading to misdiagnosis or delayed treatment. Diagnostic imaging is essential for accurate identification. Management typically involves surgery, with splenopexy preferred when feasible and splenectomy reserved for cases with complications.
Wandering spleen, though rare, requires prompt recognition and management to prevent complications like torsion and infarction.
游走脾是一种罕见的病症，其特征是由于脾脏支持韧带缺陷导致脾脏活动异常。延迟治疗可导致诸如扭转和梗死等严重并发症，因此早期诊断和手术干预对于预防不良后果至关重要。
一名16岁女孩反复出现严重的左季肋部疼痛，症状在六个月内逐渐加重，并伴有偶尔的呕吐。体格检查发现脾脏压痛且可触及，从左季肋部延伸至左髂窝。包括腹部超声和增强CT扫描在内的影像学检查显示脾脏肿大，伴有蒂扭转和梗死迹象，确诊为游走脾伴血管受损。遂进行了急诊脾切除术，术中发现脾脏显著肿大，伴有扭转和梗死，且无韧带附着。患者术后恢复顺利，出院前接种了肺炎球菌疫苗并接受了长期抗生素预防治疗。
游走脾常表现为非特异性症状，易导致误诊或治疗延迟。诊断性影像学检查对于准确识别至关重要。治疗通常包括手术，可行时首选脾固定术，对于有并发症的病例则行脾切除术。
游走脾虽罕见，但需及时识别和处理，以预防扭转和梗死等并发症。
