It filters the blood and removes abnormal cells such as old and defective red blood cells, and it makes diseasefighting components of the immune system including antibodies and. Inside, the mass of splenic tissue is of two types, the red pulp and the white pulp, which do not separate into regions but intermingle and are distributed throughout the spleen. Feb 27, 2019 please use one of the following formats to cite this article in your essay, paper or report. Although most of these anomalies are congenital, there are also acquired types. It serves as a graveyard for old or flawed red blood cells oxygencarrying cells and as a storage site for blood and platelets essential for clotting. Wandering spleen or pelvic spleen is a rare medical disease caused by the loss or.
Apr 25, 2012 wandering spleen is a rare condition that occurs when the spleen lacks one or more of the ligments that hold the spleen in its normal position in the upper left abdomen. Cureus torsion of wandering spleen with infarction. Wandering spleen is a rare clinical condition which presents with a variety of symptoms with abdominal pain, abdominal mass, and acute abdomen. Spleen introduction information on the following lesions is available in this section. He has maintained an interest in splenic pathology, particularly lymphomas involving the spleen, for many years. Torsion of a wandering spleen with whorled appearance of. Available in any file format including fbx, obj, max, 3ds, c4d. Wandering spleen on a 68gadotatoc petct scan nele lips 0 1 christophe m. The spleen is a fist sized organ located in the left upper quadrant of the abdomen. Pleural cavity separates spleen and diaphragm from the rib. The spleen has a unique location, embryological development and histological structure that differs significantly from other lymphoid organs. As the lymph nodes are filters for the lymphatic circulation, the spleen is the primary filtering element.
Posttraumatic torsion of wondering spleen is extremely rare cause of acute abdominal pain in children with only few cases reported. After a bicycle crash and a period of persistent fever family physician performed an ultrasound of abdomen which showed a round focal lesion of. Apr 25, 2012 because wandering spleen can cause lifethreatening complications such as splenic infarction, portal hypertension, and hemorrhage, surgery to remove the spleen is the preferred treatment method for patients. Sep 14, 2017 wandering spleen is an extremely rare birth defect in which there is complete absence or weakness of the ligaments which holds the spleen together in its normal anatomical position in the upper left abdomen. Volume 47, issue 1, januaryfebruary 2018, pages 6870. It can prove to be a diagnostic challenge with high mortality if misdiagnosed. Abdominal us detects enlarged spleen and doppler shows decreased perfusion of the spleen, as we observed in our case. Splenopexy surgically fixing the floating spleen is associated. The spleen is delivered to the midline by means of blunt and sharp dissection of the areolar plane between the kidney and the pancreas. As a result, the spleen is hypermobile and may be predisposed to hilar torsion and subsequent infarction, making it a potentially fatal abdominal emergency. The incidence is spleen is the major complication of an abnormally mobile spleen, the wandering spleen. In man the spleen starts forming at the end of the first month of fetal life in the mesenchyma, under the dorsal mesentery.
Use filters to find rigged, animated, lowpoly or free 3d models. The red pulp is a network of splenic cords cords of billroth and sinusoids. The story of the spleen thank you for reading the bloodhungry spleen. The spleen is located on the left side of the abdomen and weighs around 200 g in the average healthy adult.
The spleen and some of its diseases provides information pertinent to the fundamental aspects of the spleen. Pdf wondering spleen syndrome,case study researchgate. Wandering spleen is also called displaced spleen, drifting spleen, splenoptosis, floating spleen, or splenic ptosis. The spleen varies in shape from flat and ribbonlike, for example, in rodents and carnivores, to round, for example, in salientians, testudinates, and cetaceans. A yearold girl visited our hospital complaining of abdominal pain, diarrhea and vomiting. Freeman, in clinical ultrasound third edition, 2011. Sonographic diagnosis of torsion of a wandering spleen that remains in the left upper quadrant is more difficult but a splenic hilar mass, representing the torted. This book discusses the role that spleen plays in the etiology of diseases whose most obvious symptoms are evoked by associated or consecutive affections of other organs. Contrastenhanced computed tomography ct is the best imaging tool to make this diagnosis, although ultrasound may be used as well.
Its network of trabeculae, blood vessels and lymphoid tissue provides an environment in which white blood cells lymphocytes proliferate while old damaged red blood cells erythrocytes are recycled. It is a result of congenital anomalies in the development of the dorsal mesogastrium and the absence or malformation of normal splenic suspensory ligaments. Wandering spleen, whether it is a condition with which a baby is born congenital form or is the result of multiple births in women or some sort of accident that may affect men and women acquired form, is an extremely rare disorder. May 17, 2020 the spleen is a fist sized organ located in the left upper quadrant of the abdomen. This lies centrally near the pelvic inlet and displaces the bladder to the right. Report of two cases ahmet turhan, selin kapan, murat gonenc, mahmut dogan, ersan aygunbakirkoy dr sadi konuk research and training hospital, general surgery clinic, istanbul, turkeyabstract. Bloodhungry spleen curriculum guide 4406 page 2 of 7 introduction. The spleen is a fistsized organ in the upper left side of your abdomen, next to your stomach and behind your left ribs. It is structurally complex and has a number of different functions such as immunological monitoring of bloodborne antigens, storage of. The anatomy and embryology of the spleen are well described in standard texts on those subjects 1. It is the largest lymphoid organ and thus the largest filter of blood in the human body. Philip lanzkowsky, in lanzkowskys manual of pediatric hematology and. Detailed anatomical and embryological descriptions have been purposely omitted from this chapter, which concentrates on the surgical relevance of spleen related structures and their development. The wandering spleen is a condition in which the spleen is not found in its usual location or orientation in the left upper quadrant.
We present the case of a 27yearold woman of arabic. Ive been writing poems pretty much since i could write. Presentation of case wandering or ectopic spleen is a spleen, which is situated outside its normal location with fewer than 500 cases. Wandering spleen is a rare condition that occurs when the spleen lacks one or more of the ligments that hold the spleen in its normal position in the upper left abdomen.
If a person is born with this condition it is referred to as congenital wandering spleen. Splenic torsion is a rare cause of acute or recurrent abdominal pain during pregnancy or postpartum 1,5. Spleen birte steiniger, university of marburg, marburg, germany the spleen is a secondary lymphoid organ present in all vertebrates. It is structurally complex and has a number of different functions such as immunological monitoring of bloodborne antigens, storage of blood and destruction of aged or abnormal blood cells. Patient symptomatology is variable and ranges from mere feeling of an abdominal lump to sudden abdominal pain due to infarction. An ectopic or wandering spleen results from abnormal ligamentous laxity failing to fixate the spleen in its normal location in the left upper quadrant. Lies just beneath the left half of the diaphragm close to 9,10 and 11 ribs and on the left side of abdomen. Fewer than 500 cases of wandering spleen have been reported in the medical literature. Wandering spleen genetic and rare diseases information. Wandering spleen is defined as mobile spleen that is attached only by an elongated vascular pedicle, allowing it to migrate to any part of the abdomen or pelvis. Bielen department of radiology, university hospital gasthuisberg, leuven, belgium a 71yearold woman was referred to.
Wandering spleen, which is defined as a spleen without peritoneal attachments, is a rare disease and a delay in the clinical andor radiological diagnosis may lead to splenic torsion, infarction. It is imperative not to miss this diagnosis as it can lead to lifethreatening complications in the form of splenic torsioninfarction. Patients presenting with the triad epigastralgia, vomiting followed by retching, and difficulty or inability to pass a nasogastric tube into the stomach are likely to have gastric volvulus. Acute abdomen due to torsion of the wandering spleen. Because a clinical diagnosis is difficult to determine, imaging studies are necessary. Ultrasonography and ct scan revealed a solid tumor in the left lower abdomen. Acute abdomen due to torsion of the wandering spleen in a. Congenital anomalies affecting the shape of spleen are lobulations, notches, and clefts. We present a case of a 36yearold afghan female who presented with an acute abdomen, and. The spleen can be found in any part of the abdomen or. Congenital anomalies affecting the shape of spleen are lobulations. Wandering spleen is most commonly lo cated in the lower abdomen or pelvis.
Preventing infarction is the aim of a prompt surgery that can preserve the spleen and then proceed to splenopexy. A case of torsion of the wandering spleen presenting as. The spleen has a unique location, embryological development and histological structure that differs significantly from other lymphoid organs special histological features define several important functions of the spleen. We report a case of a 9yearold boy with wandering spleen torsion after bike crash and subacute clinical presentation. Wandering spleen article about wandering spleen by the. Wandering spleen is a rare condition in which the spleen migrates from its usual anatomical position, commonly to the lower abdomen or pelvis. It can be complicated by a volvulus, which is a surgical abdominal emergency. Any ligament laxity or defect will result in a rare condition called wandering spleen.
Martin conducted the first splenectomy and in 1895 when ludwik rydygier carried out the first splenopexy to immobilize a wandering spleen. The spleen university of tennessee college of medicine. Wandering spleen is a rare entity that results from the absence or maldevelopment of the ligaments that support the spleen in its normal location. Wandering spleen is a very rare defect characterized by the absence or weakness of one or more of the ligaments that hold the spleen in its normal position in the upper left abdomen.
Sep 10, 2008 a wandering spleen is a rare but wellknown entity. Some think it was mistranslated as spleen, but the roles attributed to the spleen organ truly encompass both the pancreas and. Wandering spleen is a rare entity in which the spleen is attached by a long, vascular pedicle and is without its usual peritoneal attachments. Although it may seem dispensable as it is possible to live without it, the spleen is constantly. Wandering spleen is a rare condition in which the spleen is excessively mobile and migrates from its expected position to ectopic sites in the abdomen or pelvis fig. Please use one of the following formats to cite this article in your essay, paper or report. Epidemiology wandering spleen is rare, with a reported incidence of wandering spleen, which is defined as a spleen without peritoneal attachments, is a rare disease and a delay in the clinical andor radiological diagnosis may lead to splenic torsion, infarction. In the other, it was the second episode and a firm midabdominal mass was found.
Wandering spleen nord national organization for rare. Multidetector row ct appearance ofacute torsion ofwandering spleen in a child. The possibi lity of torsion is very high as a result of the long. Pdf wandering spleen causing recurrent abdominal pain. The importance of recognizing wandering spleen as a cause of.
In man the spleen starts forming at the end of the first month of fetal life in. Wandering spleen results from abnormality of the suspensory ligaments of the spleen, namely the gastrosplenic and lienorenal ligaments. A hypermobile spleen, the socalled wandering spleen. Postraumatic torsion of wandering spleen in 9yearold boy. It can present as a painful abdominal or pelvic mass, fig. Spleen, organ of the lymphatic system located in the left side of the abdominal cavity under the diaphragm, the muscular partition between the abdomen and the chest. In humans it is about the size of a fist and is well supplied with blood. Wandering spleen is a rare condition defined as a mobile spleen only attached with its pedicle.
The spleen is encased in a thick connectivetissue capsule. Blood examination revealed slight anemia, inflammatory changes and elevated ca125 value 465 iuml. The surgeon and the spleen itp low platelet, normal bone marrow, abscess of other causes increased platelet destruction mediated by autoantibodies to platelet membrane antigens that results in platelet phagocytosis by the spleen 72% pts 10yrs are female, 70% of affected females less than 40yrs. Wandering spleen is a rare condition in which the spleen is excessively mobile and. A torted wandering spleen is a rare clinical occurrence with fewer than 500 cases reported and an incidence of less than 0.
Know the causes, symptoms, treatment of wandering spleen. The white pulp is lymphoid tissue that usually surrounds splenic blood vessels. The wandering spleen is a specific clinical syndrome which should be taken into. Bridget wilkins is a clinical senior lecturer in pathology at southampton university and an honorary consultant histopathologist for the southampton university hospitals nhs trust. Wikipedia article, commons category, wikidata item.
Deroose 0 1 didier bielen 0 1 peter bossuyt 0 1 luc mortelmans 0 1 0 p. Spleen problems and spleen removal some people are born without a spleen or need to have it removed because of illness or injury. Torsion of a wandering spleen with whorled appearance of the. Wandering spleen article about wandering spleen by the free. Laparoscopic splenectomy is the typical method used for spleen removal. In one, the onset was sudden and, on physical examination, a mass was felt in the left hypochondrium. Wandering spleen definition of wandering spleen by medical. The spleen also clears bacteria and is important for proper immune function, especially in fighting bacteria. Wandering spleen is a rare clinical entity, in which the spleen is free to move from its anatomic position to the lower abdomen or pelvis. Wandering spleen is an extremely rare birth defect in which there is complete absence or weakness of the ligaments which holds the spleen together in its normal anatomical position in the upper left abdomen. There is normal enhancement, with no evidence of acute splenic infarction although peripheral coarse calcifications may reflect previous events. Imaging findings on ct include identification of a spleen in an abnormal location fig. A wandering spleen may also be associated with gastric volvulus. Bossuyt department of gastroenterology, az imelda, bonheiden, belgium 1 d.
The spleen has a special place in my heart lubdubb because it was my first book published at a major house, candlewick press. A 35yearold woman was admitted to the hospital for close examination because she was pointed out having a tumor in the left flank at a medical checkup. The spleen is the largest organ of your lymphatic system, a subdivision of the immune system. With the spleen retracted medially, the phrenicocolic ligament is incised. There may either be a congenital absence or underdevelopment of these ligaments, or an acquired laxity. Ligamentous laxity can be acquired due to conditions, such as splenomegaly or pregnancy, but is often congenital.
The resultant elongated splenic pedicle predisposes to splenic torsion and infarct. A case of torsion of the wandering spleen is reported. Gastric volvulus is a rare but potentially lifethreatening clinical entity due to possible gastric necrosis. The spleen is an organ that lies behind the stomach on the left side of the abdomen. Honestly, what does that mysterious organ in your stomach do. It is brought about through laxity of the gastrosplenic and splenorenal ligaments. Pdf normal structure, function, and histology of the spleen. Wandering spleen or pelvic spleen is a rare medical disease caused by the loss or weakening of the ligaments that help to hold the spleen stationary. The article presents two cases of wandering spleen in the pediatric age group. Acquired wandering spleen may occur during adulthood due to injuries or other underlying conditions. Spleen can have a wide range of anomalies including its shape, location, number, and size.
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