Emergency laparoscopic splenectomy for torsion of wandering spleen in a geriatric patient: A case report
| Autor: | Novia Ayuning Nastiti, Phong Jhiew Khoo, Muhammad S. Niam |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Torsion
medicine.medical_specialty medicine.medical_treatment Splenectomy Infarction Physical examination Article Acute abdomen 03 medical and health sciences 0302 clinical medicine Laparoscopic medicine otorhinolaryngologic diseases medicine.diagnostic_test business.industry Wandering spleen fungi Pelvic cavity medicine.disease Abdominal mass Surgery body regions medicine.anatomical_structure 030220 oncology & carcinogenesis Radiological weapon 030211 gastroenterology & hepatology medicine.symptom business Geriatric |
| Zdroj: | International Journal of Surgery Case Reports |
| ISSN: | 2210-2612 |
| Popis: | Highlights • Wandering spleen is rare in geriatric / elderly population. • Wandering spleen torsion may present as acute abdomen. • Imaging is needed to diagnose wandering spleen. • Imaging is essential in assessing splenic perfusion in case of torsion. • Non-viable spleen can be managed by laparoscopic splenectomy. Introduction Wandering spleen (WS) is an uncommon congenital or acquired condition where the spleen is displaced from its normal position at the left hypochondrium to anywhere within the abdominal or pelvic cavity. The incidence is extremely rare in the geriatric population. Presentation of Case We present a rare case of WS torsion in a 69-year-old elderly patient who presented with an acute abdomen. Physical examination revealed a tender right lower quadrant abdominal mass. Imaging studies confirmed the diagnosis of WS torsion with features of infarction. Subsequently, an emergency laparoscopic splenectomy was performed. Discussion A WS occurs due to the hypermobility of the spleen secondary to the absence or laxity of splenic suspensory ligaments. It is more commonly seen in children and adults in the third decade of life. Symptoms are usually attributed to the consequences of splenic vascular pedicle torsion. Exhibited symptoms might be unspecific; thus, radiological modalities are essential to determine the diagnosis and aid in planning its management. The treatment of choice is either open or laparoscopic splenopexy or splenectomy. Conclusion Due to potentially life-threatening consequences and the rarity of such cases, a thorough history, detailed physical examination, and objective investigation are the pillars to attain a prompt diagnosis for appropriate management to be conducted as soon as possible to minimise complications. |
| Databáze: | OpenAIRE |
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