A CASE OF WANDERING SPLEEN WITH TORSION OF THE PEDICLE WHICH WAS SUCCESSFULLY DIAGNOSED PREOPERATIVELY

A 23-year-old woman was seen at the hospital because of epigastralgia and nausea. Based upon the clinical findings and results of ultrasonography, computed tomography and angiography, she was diagnosed as splenic infarction due to the wandering spleen with torsion of the pedicle and the underwent an emergency surgery. Laparotomy revealed the absence of suspensory ligaments, and the spleen was twisted twice in a counterclock-wise direction around its hilum. Because blood flow was not restored by detorsion, splenectomy was performed. The wandering spleen with torsion of the pedicle is relatively rare, and only 45 such cases have been reported in the Japanese literature. Although pain or a mass resulting from this condition is generally centered in the left epigastrium, the hypogastrium may sometimes be involved. From the fact above, we need to rule out other many diseases. Regarding the treatment, splenectomy was performed on 44 out of 45 patients. Recently, possible occurrence of major infections and/or thrombosis following splenectomy has been pointed out. Occurrence and mortality rates are much higher in children than in adults, in case of major infections. Since this condition is often seen in children, it is necessary to consider the methods for preservation of the spleen, such as splenic conserving surgery and partial splenic transplantation.