Di Zhiyan, Zhao Shasha
Department of Function, Baoding Hospital, Beijing Children's Hospital Affiliated to Capital Medical University, Baoding, Hebei, China.
Front Surg. 2025 Jun 19;12:1586986. doi: 10.3389/fsurg.2025.1586986. eCollection 2025.
We report an exceptional case of 900° splenic-torsion with accessory spleen in a 17-month-old girl presenting with nonspecific vomiting and fever. Initial CT suggested an abdominal mass, ultrasonography definitively diagnosed splenic torsion through characteristic findings: absent parenchymal flow, twisted hilar vessels ("whirlpool sign"), and preserved accessory spleen perfusion. This case highlights ultrasound's superior diagnostic capability over CT for pediatric splenic torsion, particularly in demonstrating dynamic vascular compromise. The report emphasizes key sonographic criteria and the critical 6-hour window for salvageable splenic ischemia.
我们报告了一例罕见的900°脾扭转病例，患者为一名17个月大的女童，伴有副脾，表现为非特异性呕吐和发热。最初的CT检查提示腹部有肿块，超声检查通过特征性表现明确诊断为脾扭转：实质内血流信号消失、肝门血管扭曲（“漩涡征”）以及副脾灌注良好。该病例突出了超声在诊断小儿脾扭转方面优于CT的能力，尤其是在显示动态血管受损方面。本报告强调了关键的超声诊断标准以及可挽救脾缺血的关键6小时窗口期。
