Authors: Michael Cripps Jonathan Svahn
Publish Date: 2010/05/29
Volume: 25, Issue: 1, Pages: 312-312
Abstract
A wandering spleen is a rare condition with an unknown incidence The lack of short gastric vessels and suspensory ligaments is thought to result from a fusion anomaly of the dorsal mesogastrium of the spleen The major risk in performing a splenectomy for patients with a wandering spleen is overwhelming postsplenectomy infection OPSI The incidence of OPSI is 013 to 81 with a mortality rate of 30 to 60 Laparoscopic splenopexy provides the benefits of minimally invasive surgery while avoiding the complications of splenectomy The reported case presents a patient with a wandering spleen The patient an 18yearold woman experienced a malarial infection at the age of 5 years and had a computed tomography CT scan documenting her spleen in the normal anatomic position When she was 18 years old a CT scan showed her spleen located in the right lower quadrant RLQ At laparoscopy the presence of the spleen in the RLQ was confirmed The spleen could not be easily manipulated with laparoscopic instruments so a hand port was used to mobilize the spleen to the left upper quadrant LUQ No evidence of attenuated suspensory ligaments was seen The spleen was secured in the left subdiaphragmatic location by the use of a Vicryl mesh bag An omental sling was used to support the spleen further A 1year follow up CT confirmed that the spleen still was located in the correct anatomic position This is a unique case in that the patient was known to have a normally located spleen at a young age and then found to have a wandering spleen later in life This could have resulted from a congenital fusion anomaly or attenuation of the patient’s suspensory ligaments caused by her previous malarial infection and splenomegalyThis article is published under an open access license Please check the Copyright Information section for details of this license and what reuse is permitted If your intended use exceeds what is permitted by the license or if you are unable to locate the licence and reuse information please contact the Rights and Permissions team
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