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Wandering spleen

From Surgopaedia

Aetiology

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  • Congenital failure of spleen to form normal peritoneal attachments, through failure of fusion of dorsal mesogastrium to posterior abdominal wall
  • Acquired defects in peritoneal attachments in multiparous women, due to hormonal changes and abdominal laxity

Pathophysiology

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  • Both aetiological theories lead to a long pedicle which is prone to torsion

Presentation

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  • Intermittent abdominal pain
  • Splenomegaly from venous congestion
  • Mobile mass may be palpable on examination
  • Diagnosed on CT - spleen located outside its usual position. Check for perfusion.

Treatment

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  • Splenectomy
  • Splenopexy