Wandering spleen

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
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Wandering spleen
Synonyms	Splenic ptosis, splenic torsion
Pronounce	N/A
Specialty	N/A
Symptoms	Abdominal pain, palpable abdominal mass, nausea, vomiting
Complications	Splenic infarction, Splenic rupture, Portal hypertension
Onset	Can occur at any age, more common in children and women of reproductive age
Duration	Chronic or acute
Types	N/A
Causes	Congenital or acquired laxity of the splenic ligaments
Risks	Pregnancy, trauma, connective tissue disorders
Diagnosis	Ultrasound, CT scan, MRI
Differential diagnosis	Splenomegaly, Lymphoma, Gastrointestinal stromal tumor
Prevention	N/A
Treatment	Splenectomy, splenopexy
Medication	N/A
Prognosis	Good with treatment
Frequency	Rare
Deaths	N/A

A condition where the spleen is not in its normal position

A wandering spleen is a rare medical condition characterized by the abnormal mobility of the spleen due to the absence or laxity of the ligaments that hold it in place. This condition can lead to various complications, including splenic torsion and splenic infarction.

Anatomy and Physiology

The spleen is an organ located in the upper left quadrant of the abdomen, playing a crucial role in the immune system and the filtration of blood. It is normally held in place by several ligaments, including the gastrosplenic ligament, splenorenal ligament, and phrenicocolic ligament. In the case of a wandering spleen, these ligaments are either absent or abnormally lax, allowing the spleen to move freely within the abdominal cavity.

Etiology

Wandering spleen can be congenital or acquired. Congenital wandering spleen is due to developmental anomalies in the embryonic stage, while acquired cases may result from conditions that weaken the supporting ligaments, such as trauma, pregnancy, or certain connective tissue disorders.

Clinical Presentation

Patients with a wandering spleen may present with a variety of symptoms, ranging from asymptomatic to acute abdominal pain. Common symptoms include:

• Intermittent abdominal pain
• A palpable abdominal mass
• Nausea and vomiting
• Symptoms of splenic torsion, such as acute abdominal pain and signs of peritonitis

Diagnosis

The diagnosis of a wandering spleen is typically made through imaging studies. Ultrasound and computed tomography (CT) scans are commonly used to visualize the abnormal position of the spleen and assess for complications such as torsion or infarction.

Complications

The most significant complication of a wandering spleen is splenic torsion, which can lead to:

• Splenic infarction
• Splenic rupture
• Hemorrhage

Treatment

The treatment of a wandering spleen often involves surgical intervention. The primary surgical options include:

• Splenopexy: Surgical fixation of the spleen to prevent further movement and torsion.
• Splenectomy: Removal of the spleen, typically reserved for cases where the spleen is infarcted or necrotic.

Prognosis

With appropriate surgical management, the prognosis for patients with a wandering spleen is generally good. Early diagnosis and intervention are crucial to prevent complications.

See also

• Spleen
• Splenic torsion
• Splenectomy
• Abdominal pain