Öz
Wandering spleen (WS) is a rare clinical condition resulting from an abnormally long splenic pedicle and the absence or weakening of the supporting splenic ligaments that help to hold the spleen stationary. WS is more commonly seen in females aged between 20 and 40 years. Congenital and acquired factors are reported as the predisposing factors for WS. Patients with WS may be asymptomatic, or may be evident with a painful abdominal mass or an acute abdomen due to gastrointestinal symptoms and torsion of the WS. The diagnosis of WS can be established incidentally or during the Ultrasonography (USG) or Computed Tomography (CT) explorations performed for other pathologies. A high index of suspicion aids in the diagnosis of WS. WS is mostly treated by surgery and splenopexy remains the method of choice. In the cases with persistent ischemia following detorsion, splenectomy should be performed either via laparoscopy or laparotomy. In the present report, we present a 37-year-old woman who presented with a wandering spleen causing ileus. The patient underwent laparoscopic splenectomy. Wandering spleen is a rare condition which should be suspected as a potential cause of ileus and acute abdomen
Anahtar Kelimeler
Kaynakça
- Gayer G, Zissin R, Apter S, et al. Pictorial review CT findings
- in congenital anomalies of the spleen. Br J Radiol
- ;74:767-772.
- Freeman JL, Zafar S, Jafri H, Roberts JL, Mezwa DG, Shirkhoda.
- CT of congenital and acquired abnormalities of the
- spleen. Radiographics 1993;13:597-610.
- Soleimani M, Mehrabi A, Kashfi A, et al. Surgical treatment
- of patients with wandering spleen: Report of six cases with
- a review of the literature. Surg Today 2007;37:261-269.
- Valls C, Mones L, Guma A, Lopez-Calonge E. Torsion of a
- wandering accessory spleen: CT findings. Abdom Imaging
- ;23:194-195.
- Buehner M, Baker MS. The wandering spleen. Collective
- review. Surg Gyne Obst 1992: 175: 373-387.
- Desai DC, Hebra A, Davidoff AM, Schnaufer L. Wandering
- spleen: A challenging diagnosis. Southern J Med 1997; 90:
- -443.
- Misawa T, Yoshida K, Shiba H, et al. Wandering spleen with
- chronic torsion. Am J Surg 2008;195:504–505.
- Choh SA, Choh NA, Rad I, et al. Wandering spleen presenting
- as recurrent abdominal pain in a young female. Indian J
- Pediatr 2008;75:1181–1182.
- Heydari MB, Johari HG, Eskandari S. Wandering spleen presenting
- as small bowel obstruction. Am J Emerg Med. 2013
- Jun;31:984-5. doi: 10.1016/j.ajem.2013.02.017.
- Kapan M, Gümüş M, Önder A, et al. A wandering
- spleen presenting as an acute abdomen: case report. J
- Emerg Med. 2012 Nov;43:e303-5. doi: 10.1016/j.jemermed.2010.06.029.
- Montenovo MI, Ahad S, Oelschlager BK. Laparoscopic
- splenopexy for wandering spleen: case report and review
- of the literature. Surg Laparosc Endosc Percutan Tech
- ;20:e182-4. doi: 10.1097/SLE.0b013e3181f69ce2.
Öz
Gezici dalak, dalağın uzun bir vasküler pedikül yapısı ile birlikte dalağı normal yerinde tutan peritoneal bağların yokluğu sonucu nadir görülen bir klinik tablodur. Yirmi ile kırk yaşlar arasındaki kadınlarda daha sık görülür. Konjenital ve edinilmiş faktörler etyolojide rol oynamaktadır. Klinik tablo asemptomatik olabileceği gibi bası sonucu gastrointestinal semptomlar ve torsiyon sonucu akut batı- na neden olan ağrılı abdominal bir kitle şeklinde de ortaya çıkabilir. Tanı tesadüfen veya başka patolojileri araştırırken yapılan ultrasonografi ve bilgisayarlı tomografi gibi radyolojik görüntülemelerle konulur. Şüpheci yaklaşım tanıya yardımcıdır. Tedavisi cerrahi olup splenopeksi ilk seçenek olmalıdır. Detorsiyon sonrası iskeminin devam etmesi durumunda, ya laparoskopik ya da laparotomi ile splenektomi yapılmalıdır. Bu makalede ileusa neden olan gezici dalağa sahip 37 yaşında bayan hasta sunulmaktadır. Laparaskopik splenektomi uygulanmıştır. Gezici dalak ileus ve akut karın sebepleri arasında düşünülmesi gereken nadir bir klinik tablo olduğunu düşünmekteyiz. Anahtar kelimeler: Gezici dalak, ileus, tedavi
Anahtar Kelimeler
Kaynakça
- Gayer G, Zissin R, Apter S, et al. Pictorial review CT findings
- in congenital anomalies of the spleen. Br J Radiol
- ;74:767-772.
- Freeman JL, Zafar S, Jafri H, Roberts JL, Mezwa DG, Shirkhoda.
- CT of congenital and acquired abnormalities of the
- spleen. Radiographics 1993;13:597-610.
- Soleimani M, Mehrabi A, Kashfi A, et al. Surgical treatment
- of patients with wandering spleen: Report of six cases with
- a review of the literature. Surg Today 2007;37:261-269.
- Valls C, Mones L, Guma A, Lopez-Calonge E. Torsion of a
- wandering accessory spleen: CT findings. Abdom Imaging
- ;23:194-195.
- Buehner M, Baker MS. The wandering spleen. Collective
- review. Surg Gyne Obst 1992: 175: 373-387.
- Desai DC, Hebra A, Davidoff AM, Schnaufer L. Wandering
- spleen: A challenging diagnosis. Southern J Med 1997; 90:
- -443.
- Misawa T, Yoshida K, Shiba H, et al. Wandering spleen with
- chronic torsion. Am J Surg 2008;195:504–505.
- Choh SA, Choh NA, Rad I, et al. Wandering spleen presenting
- as recurrent abdominal pain in a young female. Indian J
- Pediatr 2008;75:1181–1182.
- Heydari MB, Johari HG, Eskandari S. Wandering spleen presenting
- as small bowel obstruction. Am J Emerg Med. 2013
- Jun;31:984-5. doi: 10.1016/j.ajem.2013.02.017.
- Kapan M, Gümüş M, Önder A, et al. A wandering
- spleen presenting as an acute abdomen: case report. J
- Emerg Med. 2012 Nov;43:e303-5. doi: 10.1016/j.jemermed.2010.06.029.
- Montenovo MI, Ahad S, Oelschlager BK. Laparoscopic
- splenopexy for wandering spleen: case report and review
- of the literature. Surg Laparosc Endosc Percutan Tech
- ;20:e182-4. doi: 10.1097/SLE.0b013e3181f69ce2.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Bölüm | Olgu Sunumları |
| Yazarlar | |
| Yayımlanma Tarihi | 9 Mayıs 2015 |
| Gönderilme Tarihi | 9 Mayıs 2015 |
| Yayımlandığı Sayı | Yıl 2015 Cilt: 42 Sayı: 1 |