Radiology In Plain English

Wandering Spleen

Wandering spleen can be found on imaging studies as a spleen that is located somewhere other than it’s usual position in the left upper abdomen.  This article will discuss diagnosis, complications and treatment of wandering spleen.

What is Wandering Spleen?

A wandering spleen, also known as a floating spleen or splenoptosis, is a condition where the spleen migrates from its usual position in the upper left abdomen. The spleen is a crucial organ involved in filtering blood and fighting infections.

In individuals with a wandering spleen, the ligaments that hold the spleen in place are either elongated or weakened, allowing it to move freely within the abdomen. This mobility can lead to various health issues, including abdominal pain, bloating, and in severe cases, spleen torsion or infarction, where the blood supply to the spleen is cut off, leading to tissue death.

Symptoms of Wandering Spleen

The symptoms of a wandering spleen can vary widely from person to person. Some individuals may not experience any symptoms at all, while others may have noticeable signs. Common symptoms include:

– **Abdominal pain or discomfort:** Often reported in the lower abdomen and may vary in intensity. – **A palpable mass:** Some patients may feel a movable lump in their abdomen. – **Gastrointestinal symptoms:** Such as bloating, constipation, or indigestion.

In cases where the spleen becomes twisted (torsion), symptoms can quickly escalate to sharp abdominal pain, vomiting, and fever, necessitating immediate medical attention.

Causes and Risk Factors

The exact cause of a wandering spleen is not always clear, but it is often related to the weakening or malformation of the ligaments that secure the spleen. This condition can be congenital (present at birth) or acquired due to injury, pregnancy, or previous abdominal surgeries. Factors that may increase the risk of developing a wandering spleen include:

– **Ligamentous laxity:** Natural or acquired looseness of the ligaments. – **Trauma:** Abdominal injuries that may damage spleen ligaments. – **Pregnancy and childbirth:** Hormonal changes and physical strain can weaken abdominal structures.

Diagnosis of Wandering Spleen

Diagnosing a wandering spleen involves a combination of physical examinations, medical history, and imaging tests. Physicians may initially suspect the condition based on symptoms and a physical exam. Diagnostic imaging, such as ultrasound, CT scans, or MRI, plays a crucial role in confirming the diagnosis by visually locating the spleen’s position and assessing its condition.

Treatment Options

The treatment for a wandering spleen depends on the severity of the symptoms and the overall health of the patient. Options include:

– **Observation:** In asymptomatic cases, regular monitoring may be recommended. – **Surgical intervention:** For symptomatic patients, surgery is often necessary. The two main surgical options are: – **Splenopexy:** Reattaching the spleen to its correct position using synthetic materials or tissue. – **Splenectomy:** Removal of the spleen, typically reserved for cases where the spleen is damaged or has become necrotic.

Post-Treatment Care and Considerations

After treatment for a wandering spleen, patients will need to follow up with their healthcare provider for regular check-ups. If the spleen was removed, vaccinations against certain bacteria may be recommended since the spleen plays a critical role in fighting infections. Patients who undergo splenopexy should avoid activities that may risk abdominal trauma to prevent recurrence.

A wandering spleen is a rare condition that can lead to significant health issues if not properly addressed. Understanding the symptoms, causes, and available treatment options is important for anyone diagnosed with this condition. With timely and appropriate medical care, individuals with a wandering spleen can lead healthy and active lives. Always consult with a healthcare provider for an accurate diagnosis and personalized treatment plan tailored to your specific needs.

Similar Posts

Ct scan for abdominal pain.

Please read the disclaimer CT scan of the abdomen for abdominal pain is one of the most common reasons for ordering a CT scan. Abdominal pain can be caused by…

Atrophic Pancreas

Please read the disclaimer The pancreas plays an important role in our digestive system and in regulating our body’s sugar levels. However, various conditions can affect its health, leading to…

Large Amount of Fluid in The Abdomen on CT (Ascites)

Please read the disclaimer Large amount of fluid in the abdomen is always abnormal but has many causes. Often the fluid also extends into the pelvis. The medical term is…

Splenic Infarct Causes, Symptoms, Diagnosis, Treatment

Please read the disclaimer Splenic infarcts are diagnosed on imaging studies like CT and MRI.  Splenic infarcts occur when the blood supply to the spleen is compromised.  This leads to…

Porta Hepatis

Please read the disclaimer The Porta Hepatis is an essential structure in the human body. This article discusses the significance of Porta Hepatis, its functions, and its role in maintaining…

Renal Enlargement

Please read the disclaimer Renal enlargement is a condition where one or both kidneys are larger than normal. This situation can arise from various underlying causes and might indicate either…

Radiopaedia.org

  • Wandering spleen
  • Report problem with article
  • View revision history

Citation, DOI, disclosures and article data

At the time the article was created Elena Trajcevska had no recorded disclosures.

At the time the article was last revised Mostafa Elfeky had no financial relationships to ineligible companies to disclose.

  • Floating spleen
  • Splenic ptosis
  • Ectopic spleen
  • Splenoptosis
  • Drifting spleen
  • Systopic Spleen
  • Displaced spleen

Wandering spleen is a rare condition in which the spleen migrates from its usual anatomical position, commonly to the lower abdomen or pelvis.

On this page:

Epidemiology, clinical presentation, radiographic features, treatment and prognosis.

  • Related articles

Cases and figures

Wandering spleen is rare, with a reported incidence of <0.5%.

Diagnosis is most commonly made between the ages of 20-40 years and is more common in multiparous women 1,6 .

A wandering spleen can be an elusive diagnosis as its presentation is greatly variable and intermittent torsion can cause non-specific signs and symptoms.

It can present as an asymptomatic or painful abdominal mass, intermittent abdominal pain, or as an acute abdomen (e.g.  bowel obstruction , acute pancreatitis ) 3,4,6 .

The abnormal mobility of the spleen is caused by an abnormality of its suspensory ligaments. There may be a congenital absence or underdevelopment of these ligaments, or an acquired laxity of the ligaments caused by various conditions, such as pregnancy or diseases causing splenomegaly . Due to these abnormal ligaments, a long vascular pedicle may form, containing the splenic vessels, predisposing the spleen to torsion and consequently splenic infarction   4 .

There are various causes, mostly related to splenomegaly .

  • sickle cell disease
  • heterotaxy syndrome
  • lymphoproliferative disease
  • mononucleosis

ADVERTISEMENT: Supporters see fewer/no ads

The often non-specific clinical presentation of a wandering spleen makes radiological evaluation invaluable in its diagnosis. Performing the radiological investigations in different positions allows identification of the wandering spleen’s inclination to wander.

Plain radiograph

A wandering spleen is not frequently diagnosed on plain film radiography, but findings on abdominal x-ray may include 3,6 :

  • absence of splenic shadow in the left upper quadrant
  • space-occupying soft tissue mass in an abnormal location
  • distended bowel loops

Can be used to identify an abnormal anatomical position of the spleen, usually low-lying, or an absence of the spleen in the left upper quadrant 3,5 . It has been described that the mobility of the spleen can be demonstrated when scanning in the right decubitus position, with the migration of the spleen to the dependent position on the right side 6 . There may also be a finding of a characteristic comma-shaped spleen in an extra-anatomical position 4 .

Doppler ultrasound

Doppler ultrasound can demonstrate the vascular flow to the spleen and help diagnose splenic torsion or infarction 6 .

CT with contrast can be useful in identifying the displaced spleen and demonstrating the degree of organ ischemia in the setting of torsion and infarction of the spleen 1 .

Possible findings include 4,5,7 :

  • absence of the spleen in the left upper quadrant
  • ovoid or comma-shaped abdominal mass
  • whirl sign : a whirled appearance of hyperdense, non-enhancing splenic vessels
  • enlarged spleen, with minimal or no enhancement
  • signs of splenic hypoperfusion: heterogeneous, capsular (rim-like) or globally decreased enhancement

Nuclear medicine

Technetium sulfur colloid liver-spleen scan can be used to identify an abnormal abdominal mass as the spleen 1 .

A wandering spleen is treated surgically, ideally by detorsion and splenopexy. However, if there is evidence of hypersplenism , thrombosis , or infarction , splenectomy may be necessary. Laparoscopic techniques for both splenopexy and splenectomy are preferred, as they offer the benefits of minimally invasive surgery 2-4 .

  • 1. Wallace S, Herer E, Kiraly J, Valikangas E, Rahmani R. A Wandering Spleen: Unusual Cause of a Pelvic Mass. Obstet Gynecol. 2008;112(2 Pt 2):478-80. doi:10.1097/AOG.0b013e3181809671 - Pubmed
  • 2. Magowska A. Wandering Spleen: A Medical Enigma, Its Natural History and Rationalization. World J Surg. 2013;37(3):545-50. doi:10.1007/s00268-012-1880-x - Pubmed
  • 3. Lebron R, Self M, Mangram A, Dunn E. Wandering Spleen Presenting as Recurrent Pancreatitis. JSLS. 2008;12(3):310-3. PMC3015861 - Pubmed
  • 4. Bouassida M, Sassi S, Chtourou M et al. A Wandering Spleen Presenting as a Hypogastric Mass: Case Report. Pan Afr Med J. 2012;11:31. PMC3325069 - Pubmed
  • 5. Raissaki M, Prassopoulos P, Daskalogiannaki M, Magkanas E, Gourtsoyiannis N. Acute Abdomen Due to Torsion of Wandering Spleen: CT Diagnosis. Eur Radiol. 1998;8(8):1409-12. doi:10.1007/s003300050562 - Pubmed
  • 6. Taori K, Sanyal R, Deshmukh A, Saini T. Pseudocyst Formation: A Rare Complication of Wandering Spleen. Br J Radiol. 2005;78(935):1050-2. doi:10.1259/bjr/33073529 - Pubmed
  • 7. Lam Y, Yuen K, Chong L. Acute Torsion of a Wandering Spleen. Hong Kong Med J. 2012;18(2):160-2. - Pubmed
  • 8. Yildiz A, Ariyurek M, Karcaaltincaba M. Splenic Anomalies of Shape, Size, and Location: Pictorial Essay. The Scientific World Journal. 2013;2013:1-9. doi:10.1155/2013/321810 - Pubmed

Incoming Links

  • Splenectomy
  • Gastric volvulus
  • Splenunculus
  • Splenic lesions and anomalies
  • Splenic infarction
  • Hypersplenism
  • Autosplenectomy
  • Splenic volvulus
  • Wandering accessory spleen with torsion of vascular pedicle
  • Wandering accessory spleen
  • Wandering spleen with volvulus and infarction
  • Mesentero-axial volvulus
  • Wandering spleen with partial torsion
  • Mesentero-axial gastric volvulus
  • Cavernous transformation of the portal vein
  • Torsion of a wandering spleen
  • Splenic hypoperfusion due to torsion
  • Infarcted wandering spleen
  • Inguinal node metastasis and wandering spleen

Related articles: Splenic pathology

  • normal appearance of the spleen
  • pseudolesion of the spleen: inhomogeneous splenic enhancement
  • intrapancreatic accessory spleen
  • wandering spleen
  • polysplenia
  • splenogonadal fusion
  • retrorenal spleen
  • splenic cyst  ( mnemonic )
  • splenic pseudocyst
  • splenic hemangioma
  • splenic lymphangioma
  • splenic hamartoma
  • sclerosing angiomatoid nodular transformation (SANT)
  • extramedullary hematopoiesis in the spleen
  • splenic abscess
  • tuberculosis
  • Littoral cell angioma of the spleen
  • inflammatory myofibroblastic tumor of the spleen
  • primary angiosarcoma of the spleen
  • hemangiopericytoma of the spleen
  • splenic metastases
  • splenic tuberculosis
  • histoplasmosis
  • splenic siderosis
  • splenic amyloidosis  
  • autosplenectomy
  • splenic hydatid infection
  • hypersplenism
  • hyposplenism
  • increased splenic density
  • splenic calcification
  • splenic infarction
  • splenic trauma injury grading
  • incidental splenic lesion (approach)

Related articles: Anatomy: Abdominopelvic

Anatomy: Abdominopelvic

  • lumbar spine
  • pubic symphysis
  • obturator foramen
  • greater sciatic notch
  • lesser sciatic notch
  • sacral hiatus
  • sacrotuberous ligament
  • sacrospinous ligament
  • greater sciatic foramen
  • lesser sciatic foramen
  • anterior angulation of the coccyx
  • sternocostal triangle
  • Scarpa's fascia
  • inguinal ligament
  • lacunar ligament
  • conjoint tendon
  • transversus abdominis muscle
  • rectus sheath
  • arcuate line
  • semilunar line
  • transversalis fascia
  • pyramidalis muscle
  • surface anatomy
  • psoas major muscle
  • psoas minor muscle
  • quadratus lumborum muscle
  • iliacus muscle
  • levator ani muscle
  • coccygeus muscle
  • piriformis muscle
  • obturator internus muscle
  • superior lumbar triangle
  • inferior lumbar triangle
  • iliopsoas compartment
  • left triangular ligament
  • right triangular ligament
  • ligamentum teres
  • veins of Sappey
  • hepatogastric ligament
  • gastrosplenic ligament
  • splenorenal ligament
  • root of the mesentery
  • mesoappendix
  • transverse mesocolon
  • sigmoid mesocolon
  • right subphrenic space
  • anterior right subhepatic space
  • posterior right subhepatic space (Morison pouch)
  • epiploic foramen (of Winslow)
  • anterior left subhepatic space
  • posterior left subhepatic space
  • anterior left subphrenic space
  • posterior left subphrenic (perisplenic) space
  • right inframesocolic space
  • left inframesocolic space
  • right paracolic gutter
  • left paracolic gutter
  • inguinal canal ( mnemonic )
  • Hesselbach triangle
  • median umbilical fold
  • medial umbilical folds
  • lateral umbilical folds
  • perirenal fascia
  • anterior pararenal space
  • perinephric bridging septa (of Kunin)
  • properitoneal fat
  • great vessel space
  • lateroconal fascia
  • rectouterine pouch (pouch of Douglas)
  • rectovesical pouch
  • retropubic space (of Retzius)
  • lateral fossa
  • supravesical fossa
  • presacral space
  • canal of Nuck
  • pudendal canal
  • obturator canal
  • superficial perineal pouch
  • perineal membrane
  • deep perineal pouch
  • deep transverse perineal muscles
  • superficial transverse perineal muscles
  • ischioanal fossa
  • urogenital diaphragm
  • phrenic ampulla
  • rugal folds
  • Brunner gland
  • duodenojejunal flexure
  • Meckel diverticulum
  • ileocecal valve
  • jejunum vs ileum
  • valvulae conniventes
  • duplex appendix
  • ascending colon
  • right colic flexure
  • transverse colon
  • left colic flexure
  • loop-to-loop colon
  • sigmoid colon
  • mesorectal fascia
  • appendix epiploica
  • haustral folds
  • taeniae coli
  • anal sphincters
  • splenunculus
  • beaver tail liver
  • ligamentum venosum
  • porta hepatis
  • Riedel lobe
  • segmental liver anatomy  ( mnemonic )
  • supradiaphragmatic liver
  • common hepatic duct
  • cystic duct
  • ampulla of Vater
  • sphincter of Oddi
  • subvesical bile ducts
  • gallbladder duplication
  • gallbladder triplication
  • gallbladder agenesis
  • Rokitansky-Aschoff sinuses
  • Phrygian cap
  • septate gallbladder  
  • adrenal arteries
  • adrenal veins
  • chromaffin cells
  • horseshoe adrenal gland
  • pancreatic duct diameter
  • pancreas divisum
  • meandering main pancreatic duct
  • ansa pancreatica
  • anomalous pancreaticobiliary junction
  • ectopic pancreatic tissue
  • annular pancreas
  • organs of Zuckerkandl
  • extrarenal pelvis
  • renal sinus
  • avascular plane of Brodel
  • renal agenesis
  • supernumerary kidney
  • sigmoid kidney
  • crossed fused renal ectopia
  • junctional parenchymal defect
  • pancake kidney
  • fused pelvic kidney
  • intrathoracic kidney
  • crossed renal ectopia
  • abnormal renal rotation
  • nephroptosis
  • persistent fetal lobulation
  • hypertrophied column of Bertin
  • renal hilar lip
  • dromedary hump
  • faceless kidney
  • ectopic ureter
  • Weigert-Meyer law
  • bifid ureter
  • ureteral duplication
  • retrocaval ureter
  • ureterocele
  • bladder neuroanatomy (micturition)
  • fossa navicularis
  • verumontanum
  • prostatic utricle
  • musculus compressor nuda
  • paraurethral ducts
  • metanephric blastema
  • ureteric bud
  • Wolffian duct
  • seminal vesicles
  • ejaculatory duct
  • bulbourethral glands
  • urethral glands of Littré
  • ductus deferens
  • cremaster muscle
  • dartos muscle
  • tunica vaginalis
  • tunica albuginea
  • appendix of the testis
  • appendix of the epididymis
  • bilobed testis
  • labia majora
  • labia minora
  • bulbs of the vestibule
  • vestibule of the vulva
  • Bartholin glands
  • parametrium
  • endometrium
  • basal plate
  • chorionic plate
  • variation in morphology
  • retroplacental complex
  • Wharton jelly
  • Fallopian tubes
  • dominant ovarian follicle
  • primary follicle
  • secondary follicle
  • mature vesicular follicle
  • corpus luteum
  • corpus albicans
  • cumulus oophorus
  • broad ligament  ( mnemonic ) 
  • retroverted uterus
  • transverse vaginal septum
  • uterus didelphys
  • bicornuate uterus
  • septate uterus
  • uterine agenesis
  • unicornuate uterus
  • arcuate uterus
  • T-shaped uterus
  • Mullerian duct
  • superior suprarenal artery
  • falciform artery
  • cystic artery
  • supraduodenal artery
  • right gastroepiploic artery
  • superior pancreaticoduodenal artery
  • right gastric artery
  • left gastric artery
  • left gastroepiploic artery
  • short gastric arteries
  • greater pancreatic artery
  • dorsal pancreatic artery
  • transverse pancreatic artery
  • inferior pancreaticoduodenal artery
  • jejunal and ileal branches
  • accessory appendicular artery
  • colic branch
  • right colic artery
  • middle colic artery
  • middle suprarenal artery
  • inferior suprarenal artery
  • gonadal artery ( ovarian artery | testicular artery )
  • left colic artery
  • sigmoid arteries
  • superior rectal artery
  • lumbar arteries
  • median sacral artery
  • cremasteric artery
  • deep circumflex artery
  • umbilical artery
  • deferential artery
  • obturator artery
  • vaginal artery
  • inferior vesical artery
  • uterine artery
  • middle rectal artery
  • inferior rectal artery
  • posterior scrotal artery
  • transverse perineal artery
  • artery to the bulb
  • deep artery of the penis/clitoris
  • dorsal artery of the penis/clitoris
  • inferior gluteal artery
  • iliolumbar artery
  • lateral sacral artery
  • superior gluteal artery
  • persistent sciatic artery
  • corona mortis
  • inferior mesenteric vein
  • superior mesenteric vein
  • left gastric vein (coronary vein)
  • accessory right inferior hepatic vein
  • ascending lumbar communicant vein
  • pampiniform plexus
  • suprarenal vein
  • double retroaortic left renal vein
  • circumaortic left renal vein
  • pancreaticoduodenal veins
  • internal pudendal vein
  • obturator vein
  • prostatic venous plexus
  • vesical venous plexus
  • uterine venous plexus
  • vaginal venous plexus
  • external iliac vein
  • absent infrarenal inferior vena cava
  • azygos continuation
  • circumcaval ureter
  • circumaortic venous collar
  • Eustachian valve
  • left-sided IVC
  • IVC duplication
  • arc of Barkow
  • arc of Buhler
  • arc of Riolan
  • marginal artery of Drummond
  • portal-systemic venous collateral pathways
  • Griffiths point
  • Sudeck point
  • para-aortic lymph nodes
  • preaortic lymph nodes
  • portal and portocaval lymph nodes
  • gastric lymph node stations
  • peripancreatic lymph nodes
  • common iliac lymph nodes
  • external iliac lymph nodes
  • internal iliac lymph nodes
  • cisterna chyli
  • thoracic splanchnic nerves
  • subcostal nerve
  • Iliohypogastric nerve
  • ilioinguinal nerve
  • genitofemoral nerve
  • lateral femoral cutaneous nerve
  • femoral nerve
  • obturator nerve
  • lumbosacral trunk
  • sciatic nerve
  • superior gluteal nerve
  • inferior gluteal nerve
  • nerve to piriformis
  • perforating cutaneous nerve
  • posterior femoral cutaneous nerve
  • parasympathetic pelvic splanchnic nerves
  • perineal branch
  • inferior rectal nerve
  • dorsal nerve of the penis or clitoris
  • nerve to quadratus femoris and inferior gemellus muscles
  • nerve to internal obturator and superior gemellus muscles
  • phrenic plexus
  • celiac plexus
  • hepatic plexus
  • aorticorenal plexus
  • renal plexus
  • superior mesenteric plexus
  • inferior mesenteric plexus
  • superior hypogastric plexus
  • inferior hypogastric plexus
  • ganglion impar

Promoted articles (advertising)

wandering spleen french

Loading more images...

Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys

Loading Stack -

0 images remaining

By Section:

  • Artificial Intelligence
  • Classifications
  • Imaging Technology
  • Interventional Radiology
  • Radiography
  • Central Nervous System
  • Gastrointestinal
  • Gynaecology
  • Haematology
  • Head & Neck
  • Hepatobiliary
  • Interventional
  • Musculoskeletal
  • Paediatrics
  • Not Applicable

Radiopaedia.org

  • Feature Sponsor
  • Expert advisers

wandering spleen french

Wandering Spleen in a Patient With Significant Medical History

Affiliations.

  • 1 Department of Medicine, University of Missouri, Columbia, USA.
  • 2 Department of Trauma Research, Mercy Hospital, Springfield, USA.
  • 3 Department of General and Trauma Surgery, Mercy Hospital, Springfield, USA.
  • PMID: 37007360
  • PMCID: PMC10056767
  • DOI: 10.7759/cureus.35543

The clinical presentation of a wandering spleen is characterized mainly by unspecific acute symptoms, ranging from diffuse abdominal pain to left upper/lower quadrant and referred shoulder pain to asymptomatic. This has challenged accelerated medical care and impeded the acquisition of confirmatory diagnosis; therefore, increasing morbidity and mortality risks. Splenectomy is an established operative procedure for a wandering spleen. However, there has not been enough literature emphasizing the clinical history of congenital malformations and surgical corrections as inferential tools for facilitating a decisive and informed procedure. The case presented is of a 22-year-old female who reported to the emergency department with a five-day persistent left upper quadrant and left lower quadrant (LLQ) abdominal pain, associated with nausea. According to the medical history, the patient had a significant history of vertebral defects, anal atresia, cardiac anomalies, tracheoesophageal fistula, renal anomalies, and limb abnormalities (VACTERL) associated with congenital anomalies. By the age of eight years, the patient had undergone multiple surgical interventions, including tetralogy of Fallot repair, an imperforate anal repair with rectal pull-through, Malone antegrade continence enema (MACE), and bowel vaginoplasty. Computed tomography imaging of the abdomen revealed evidence of a wandering spleen in the LLQ with associated torsion of the splenic vasculature (whirl sign). Intra-operatively, appendicostomy was identified extending from the cecum in a near mid-line position, to the umbilicus, and carefully incised distally, preventing injury to the appendicostomy. The spleen was identified in the pelvis, and the individual vessels were clamped, divided, and ligated. Blood loss was minimal with no post-operative complications. This rare case report adds valuable teaching points about the treatment of wandering spleen in individuals with VACTERL anomalies.

Keywords: appendicostomy; malone antegrade continence enema (mace); post-splenectomy vaccines; vacterl; vacterl association; wandering spleen; whirl sign.

Copyright © 2023, French et al.

Publication types

  • Case Reports
  • Search Menu
  • Why Publish with Gastroenterology Report
  • Author Guidelines
  • Submission Site
  • Open Access Options
  • Self-Archiving Policy
  • About Gastroenterology Report
  • Editorial Board
  • Advertising and Corporate Services
  • Journals Career Network
  • Journals on Oxford Academic
  • Books on Oxford Academic

Issue Cover

Article Contents

Introduction, case presentation.

  • < Previous

Wandering spleen: a surgical enigma

  • Article contents
  • Figures & tables
  • Supplementary Data

Ashok Kumar Puranik, Rohit Mehra, Sushila Chauhan, Rahul Pandey, Wandering spleen: a surgical enigma, Gastroenterology Report , Volume 5, Issue 3, August 2017, Pages 241–243, https://doi.org/10.1093/gastro/gov034

  • Permissions Icon Permissions

Wandering spleen, also referred to as ‘ptotic spleen’, is a rare clinical condition characterized by splenic migration form its normal left hypochondrial position to any other abdominal or pelvic position. Among the multifactorial etiologies proposed, laxity of the spleen’s primary supporting ligaments is the most agreed-upon hypothesis. We present one rare case of wandering spleen in an 11-year-old girl who presented with recurrent abdominal pain with no localizing features. Her abdominal examination revealed an intra-abdominal left iliac fossa lump with restricted mobility, which was confirmed as a wandering spleen by abdominal sonography and contrast-enhanced computed tomography. Intraoperatively, an infarcted spleen was encountered with tortuous, elongated, torsional splenic pedicle and a single dense adhesive band with descending colon. Splenectomy was offered to the patient. Post-operatively, the patient is healthy and symptom free at one-year follow-up. The rare clinical diagnosis of this condition, particularly in the paediatric age-group, makes it an enigma for the surgical world.

Wandering spleen (WS), is a rare clinical condition, with only about 500 cases reported worldwide and an incidence rate of 0.2% [ 1 , 2 ]. One of the first documented descriptions of WS came from Dr Josef Dietl, a Polish clinician, who not only documented three cases between 1854 and 1863 but also described the laxity of splenic ligaments as the likely etiology [ 2 ]. Among the various hypotheses proposed, laxity of the spleen’s supporting ligaments is the most agreed upon. The condition leads to migration of the spleen from its normal position in the left hypochondrium to the pelvic or iliac region. This migration in turn often leads to torsion of the elongated splenic pedicle, which makes the patient symptomatic. WS is usually seen in women of child-bearing age, and the condition is particularly rare in the paediatric population [ 3 ]. We present one such rare case of a WS in a child who presented with intermittent abdominal pain that was clinically and radiologically confirmed as WS with splenic infarction. The patient was offered a splenectomy.

An 11-year-old girl presented to us with repeated episodes of intermittent, moderate-to-severe intensity, non-radiating pain in the right iliac fossa for the last six months. She had no history of fever, vomiting or urinary symptoms. On physical examination, a 10 x 4 cm intra-abdominal, ballotable, smooth-surfaced lump, which had restricted mobility with respiration, was palpated in the left iliac fossa. Her routine haematological and biochemical investigations were within normal limits. Abdominal sonography, and colour Doppler flow imaging revealed a 13 x 15 cm spleen with heterogeneous echogenicity, situated antero-inferior to the left kidney in the left iliac fossa with tortuous, elongated splenic vessels with torsion and a low blood-flow profile. Contrast-enhanced CT of the abdomen revealed a 15 x 17 cm spleen in the left iliac fossa, with a long, tortuous pedicle (approximately 15 cm) with torsion and focal areas of splenic parenchymal ischemia ( Figure 1 ).

Contrast-enhanced CT images of abdomen. (A) Coronal reformatted image shows that the spleen has migrated from the left hypochondrium and is ectopically located in the left lumbar and iliac region (marked with an arrow). (B) Sagittal reformatted image shows that the spleen is located inferior to the left kidney.

Contrast-enhanced CT images of abdomen. (A) Coronal reformatted image shows that the spleen has migrated from the left hypochondrium and is ectopically located in the left lumbar and iliac region (marked with an arrow). (B) Sagittal reformatted image shows that the spleen is located inferior to the left kidney.

The patient was scheduled for an elective splenectomy and was immunized against Hae mophilus influenza e , pneumococcus and meningococcus as per the protocol. Intraoperatively, the spleen was found in the left iliac region, antero-inferior to the left kidney. There was a dense band between the splenic hilum and descending colon, which was probably responsible for the restricted mobility of the spleen during clinical examination. A long splenic pedicle with torsion was also found. The spleen showed multiple areas of infarction. ( Figure 2 ). Keeping in view the above findings, a splenectomy was performed. The histopathological report inferred that there were several areas of extensive splenic haemorrhage and infarction with neutrophilic infiltration of the splenic vessel walls. The postoperative period has been uneventful, and the patient has been healthy and symptom free at her one-year follow-up.

Intra-operative findings. (A) The splenic vascular pedicle with torsion (marked by an arrow). (B) The dense band connecting splenic hilum with descending colon (marked by an arrow) with areas of splenic infarction.

Intra-operative findings. (A) The splenic vascular pedicle with torsion (marked by an arrow). (B) The dense band connecting splenic hilum with descending colon (marked by an arrow) with areas of splenic infarction.

Among all the solid organs in the human body, the spleen is possibly the least understood and the most discredited. Our medical knowledge on the spleen has come a long way from the days when it was considered to be the seat of laughter, associated with black bile and credited with disharmony of life, to the present day concept in which it is recognized as an important reticuloendothelial organ [ 4 ].

WS is a rare clinical facet of this organ, which was first described by Von Horne in 1667 [ 5 ]. WS is defined as the condition in which the spleen migrates from its normal position in the left hypochondrium, mostly likely due to an error in the embryological development of the primary supporting ligament of spleen with elongation of its vascular pedicle. The credit for documenting the first case of this condition goes to the Polish clinician, Dr Jozef Dietl. He not only prognosticated the life-threatening complications of this condition, he also predicted that hypoplasia of splenic ligaments was probably the major culprit [ 2 ].

Anatomically, the spleen has six peritoneal attachments (primary suspensory ligaments) that are directly associated with it (gastrosplenic, splenorenal, splenophrenic, splenocolic, pancreaticosplenic and presplenic folds) and two ligaments (pancreaticocolic and phrenicocolic) in indirect association. Failure of fusion of the dorsal mesogastrium to the posterior abdominal wall during embryogenesis leads to failure or defective attachment of these ligaments, leading to WS. The gastrosplenic, splenorenal and phrenicocolic ligaments have been primarily implicated ( Figure 3 ) [ 6 ].

Diagram depicting the suspensory ligaments of the spleen. The three suspensory ligaments usually implicated in the development of wandering spleen are (i) the gastrosplenic ligament, (ii) the splenorenal ligament and (iii) the phrenicocolic ligament.

Diagram depicting the suspensory ligaments of the spleen. The three suspensory ligaments usually implicated in the development of wandering spleen are (i) the gastrosplenic ligament, (ii) the splenorenal ligament and (iii) the phrenicocolic ligament.

A second school of thought incriminates the hormonal changes and abdominal laxity in multiparous women as an acquired cause of WS and better explains the presence of WS in women of child-bearing age [ 7 ]. Huge, heavy spleens due to malaria, infectious mononucleosis and benign haematologic diseases have also been implicated in the literature [ 8 ].

The abnormal fixation of the spleen predisposes the splenic vascular pedicle to become tortuous, elongated and prone to intermittent torsion, in turn making the spleen vulnerable to infarction [ 3 ].

Often labelled as a rare clinical diagnosis, especially in the paediatric population, the presentations of WS can be vivid [ 9 ]. The spectrum can range from an asymptomatic abdominal mass, an incidental finding on routine abdominal sonography, intermittent abdominal pain (as in our patient) and splenomegaly to severe abdominal pain and discomfort due to torsion of the splenic vascular pedicle.

Clinically, a mobile mass can be felt on abdominal examination. However, in our case the presence of a dense band between the spleen and descending colon restricted the mobility of the spleen. A sonographic examination of the abdomen usually suffices to delineate the location, size and any architectural deformities of the spleen in most cases. When the splenic vascularity is in question, either colour Doppler flow imaging or contrast-enhanced CT can both confirm the diagnosis and provide additional information on the blood flow profile in the splenic pedicle. Splenic parenchymal ischemia is characterized by a change in blood flow and a heterogeneous echogenicity of the spleen. This information plays a vital role in the pre-operative decision to offer the patient splenoplexy or splenectomy as the choice of surgery.

The surgical intervention is defined by the vascularity of the spleen. A patient with splenic infarction due to torsion of the splenic pedicle, as in our case, is offered splenectomy. Splenoplexy, either open or laparoscopic, is offered to most of the other patients in whom splenic pedicle detorsion and splenic fixation to either the diaphragm or abdominal wall are done [ 9 ]. Nonoperative management of a WS is not advised as there is a 65% chance of torsion with ischemic splenic infarction without fixation of the spleen [ 10 ].

WS is a rare condition that often presents as a clinical enigma. A clinician should have a high degree of suspicion for WS, particularly in women of child-bearing age and children who present with recurrent abdominal pain and a mobile abdominal mass. Modern imaging techniques are usually diagnostic and can identify the splenic pedicle torsion with a high degree of accuracy. Surgical intervention, in the form of either splenoplexy or splenectomy, is largely governed by the findings of pedicle torsion and the associated risk for acute splenic infarction.

Conflict of interest statement : none declared.

Gore R , Levin M . Textbook of Gastrointestinal Radiology . 2nd ed. Philadelphia : WB Saunders , 2000 : 1866 – 9 .

Google Scholar

Google Preview

Sharma A , Salerno G . A torted wandering spleen: a case report . J Med Case Rep 2014 ; 8 : 133 .

Desai DC , Hebra A , Davidoff AM et al.  . Wandering spleen: a challenging diagnosis . South Med J 1997 ; 90 : 439 – 43 .

Jackson SW . Melancholia and the waning of the humoral theory . J Hist Med Allied Sci 1978 ; 33 : 367 – 76 .

Lane TM , South LM . Management of a wandering spleen . J R Soc Med 1999 ; 92 : 84 – 5 .

Shelton J , Holzman MD . ‘The Spleen’ . In: Townsend CM , Beauchamp RD , Evers BM , Mattox KL (eds). Sabiston Textbook of Surgery. The Biological Basis of Modern Surgical Practice . 19th ed. Philadelphia : WB Saunders , 2012 : 1548 – 63

Faridi MS , Kumar A , Inam L et al.  . Wandering Spleen- A Diagnostic Challenge: Case Report and Review of Literature . Malays J Med Sci 2014 ; 21 : 57 – 60 .

Montenovo MI , Ahad S , Oelschlager BK . Laparoscopic splenopexy for wandering spleen: case report and review of the literature . Surg Laparosc Endosc Percutan Tech 2010 ; 20 : e182 – 4 .

Abell KB . Wandering spleen . Probl Gen Surg 1990 ; 7 : 122 – 7 .

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 – 9 .

  • ultrasonography
  • abdominal pain
  • computed tomography
  • splenectomy
  • surgical procedures, operative
  • abdominal examination
  • wandering spleen
  • descending colon
  • clinical diagnosis

Email alerts

More on this topic, citing articles via, affiliations.

Gastroenterology Report

  • Online ISSN 2052-0034
  • Copyright © 2024 Oxford University Press and Sixth Affiliated Hospital of Sun Yat-Sen University
  • About Oxford Academic
  • Publish journals with us
  • University press partners
  • What we publish
  • New features  
  • Open access
  • Institutional account management
  • Rights and permissions
  • Get help with access
  • Accessibility
  • Advertising
  • Media enquiries
  • Oxford University Press
  • Oxford Languages
  • University of Oxford

Oxford University Press is a department of the University of Oxford. It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide

  • Copyright © 2024 Oxford University Press
  • Cookie settings
  • Cookie policy
  • Privacy policy
  • Legal notice

This Feature Is Available To Subscribers Only

Sign In or Create an Account

This PDF is available to Subscribers Only

For full access to this pdf, sign in to an existing account, or purchase an annual subscription.

Wandering Spleen: A Medical Enigma, Its Natural History and Rationalization

  • Open access
  • Published: 13 December 2012
  • Volume 37 , pages 545–550, ( 2013 )

Cite this article

You have full access to this open access article

  • Anita Magowska 1  

2547 Accesses

44 Citations

8 Altmetric

Explore all metrics

Introduction

Wandering spleen is a rare condition in which the spleen is not located in the left upper quadrant but is found lower in the abdomen or in the pelvic region because of the laxity of the peritoneal attachments. Many patients with wandering spleen are asymptomatic, hence the condition can be discovered only by abdominal examination or at a hospital emergency department if a patient is admitted to hospital because of severe abdominal pain, vomiting or obstipation.

This article aims to provide a historical overview of wandering spleen diagnostics and surgical treatment supplemented with an analyses of articles on wandering spleen included in the PubMed database.

One of the first clinical descriptions of a wandering spleen was written by Józef Dietl in 1854. The next years of vital importance are 1877 when A. Martin conducted the first splenectomy and in 1895 when Ludwik Rydygier carried out the first splenopexy to immobilize a wandering spleen. Since that time various techniques of splenectomy and splenopexy have been developed.

Conclusions

Introducing medical technologies was a watershed in the development and treatment of wandering spleen, which is confirmed by the PubMed database. Despite the increased number of publications medical literature shows that a wandering spleen still remains a misdiagnosed condition, especially among children.

Similar content being viewed by others

wandering spleen french

Typical imaging finding of hepatic infections: a pictorial essay

Sonaz Malekzadeh, Lucien Widmer, … Harriet C. Thoeny

wandering spleen french

Point-of-care gastric ultrasound and aspiration risk assessment: a narrative review

Anahi Perlas, Cristian Arzola & Peter Van de Putte

wandering spleen french

Utility of ultrasound in acute pancreatitis

David P. Burrowes, Hailey H. Choi, … Aya Kamaya

Avoid common mistakes on your manuscript.

The development of knowledge referring to wandering spleen

Ayurveda, the classical Indian system of medical practice based on the humor doctrine, describes the spleen as “the root of the ducts which transport the blood” [ 1 ]. The ancient Greek humoral system of Hippocrates and Galen, in some ways analogous to that description, attributed to the spleen the role of an organ responsible for producing black bile, whose Greek name: μελανχολία, is the root of the English word melancholia [ 2 ]. Over hundreds of years, doctors, strongly influenced by the legacy of the humoral theory, successfully anchored the spleen in the pathogenesis of neurasthenia and hypochondria experienced by women, whereas women’s hysteria was explained as the result of wandering of the uterus. Even when advances in the field of morbid anatomy indicated the obvious absurdity of humoral theory, doctors were unable to free themselves from these stereotypical notions. It was as late as 1682 when an outstanding English physician, Thomas Sydenham (1624–1689), provided evidence for strangulation of the womb [ 3 ], whereas as recently as 1863, Józef Dietl (1804–1878) [ 4 ], an internationally acclaimed clinical doctor, wrote that a wandering spleen led women to experience hypochondria and that a wandering uterus caused hysteria. In 1908 John Duncan [ 5 ] expressed his belief that wandering organs, including a wandering spleen, are an expression of neurasthenia.

In 1653, Panoralus [ 6 ] for the first time described the spleen as a “ductless gland”. Next, in 1667 Van Horne recognized and described the phenomenon of a wandering spleen [ 7 ]. Even though post-mortem examinations were carried out more and more often in the seventeenth century, they did not provide any information as to how important the spleen could be for the human body. No wonder, then, that in 1725 Sir Richard Blackmore (1654–1729) [ 8 ], an English doctor and poet, questioned whether it is necessary to have a spleen for the human body to function normally.

In the nineteenth century the spleen still remained a medical enigma. The authors of German anatomy atlases, Robert Foriep (1804–1861), a doctor and an artist who followed Italian lithographers, and Theodor Richter (1824–1898), who was helped by a professional illustrator, did not pay much attention to the spleen. Interestingly, such a rare phenomenon as a wandering spleen kept arousing enormous interest among physicians. A wandering spleen resulted in the characteristic dullness of lung sounds on percussion and was proved by palpation. The greatest authorities in medical science widely described the diagnosis of a wandering spleen, including the Scottish doctor and philosopher John Abercrombie (1780–1844), who wrote “Researches on the Diseases of the Intestinal Canal, Liver and other Viscera of the Abdomen” (Edinburgh 1838) and the most prominent member of the Vienna School, Carl von Rokitansky (1804–1878), who described the phenomenon in the course-book “Lehrbuch der patologische Anatomie” (Textbook on Morbid Anatomy) (Vienna 1846) [ 9 ].

One of the first case reports of a wandering spleen in a child was published in 1854 by the Polish physician Józef Dietl (Fig.  1 ) in the Polish journal “Pamiętnik Towarzystwa Lekarskiego Warszawskiego” (Diary of the Warsaw Medical Society) and in ”Wiener Medizinische Wochenschrift.” Two years later Dietl [ 10 ] included in the same periodical his next observations of a case related to a wandering spleen, yet this time he took the post mortem examination into consideration. In 1863 Dietl described a third case of a wandering spleen in “Przegląd Lekarski,” a journal he founded and edited himself. It was there that he indicated this condition to be life-threatening because it led to an extensive peritonitis and consequently death. He was one of the first doctors who stated that it was not a patients’ temperament but rather relaxation, extension, or the hypoplasia of splenic ligaments that made a spleen wander. He considered wandering spleen to be a condition present in women emaciated and exhausted by extensive work. He treated the condition by using quinine (he believed it decreased the size of the spleen and improved his patients’ mood) and an abdominal compression binder made of plain linen or rubber. Surgical removal of the spleen, recommended by Friedrich Kűchenmeister (1821–1890), was considered by Dietl [ 4 ] as definitely too risky. Still, he allowed the abdominal wall to be pierced with a knife in order to provoke limited inflammation and local adhesion.

figure 1

Józef Dietl (1804–1878), a Polish physician who described one of the first cases of a wandering spleen in a child (by courtesy of the Polish National Digital Archives)

In his historical study of surgery, Ricketts [ 8 ] cited Dietl’s article published in 1863 as a classical description of clinical wandering spleen complications. This text, however, did not gain as much publicity as a clinical description of a wandering kidney incarceration on the basis of which the eponym “Dietl’s crisis” was created [ 11 ]. By no means was it a coincidence that Dietl, who was both an internist and anatomopathologist, became interested in the symptoms of both a wandering kidney and a wandering spleen, even though in the interwar period doctors considered such symptoms a single clinical problem [ 12 ].

Advances in spleen surgery

Before narcosis and antiseptic treatment had been introduced, the diagnosis of a wandering and/or enlarged spleen seldom if ever became an indication for organ removal. In 1549, Adrian Zacarelli for the first time had demonstrated removal of an enlarged spleen [ 13 ]. In the following centuries war wounds imposed on doctors the necessity for surgical treatment of the spleen. Its removal was considered necessary in cases of rupture or ulcerative stomach wounds [ 8 ], what in 1788 was first described by Giovanni Fantoni in “Opuscula Medica et Physiologica,” a work published in Geneva. Then, in 1855 Darmstadt, Julian Schultz completed the successful removal of a spleen protruding from a wound in the patient’s side [ 14 ]. The first fully documented and successful removal of a wandering spleen was carried out by Martin [ 15 ] in 1877 in Berlin. One year later Vincenz Czerny (1840–1916), in Heidelberg, made the next successful surgical removal of a wandering spleen [ 14 ].

To sum up, between 1855 and 1903 doctors conducted 360 splenectomies, 38.3 % of which resulted in the patients’ death from hemorrhage and shock (Fig.  2 ) [ 16 ]. It is worth stressing that in 1865–1875 up to 80 % of patients died after spleen removal [ 8 ]. Such a high mortality rate resulted from the fact that one of the first indications for splenectomy was not only an enlarged and/or wandering spleen but also evidence of leukemia [ 12 ]. To 1900, the mortality rate among patients with a removed spleen in the treatment of leukemia amounted to 87.7 % [ 16 ]. As late as the interwar period, all cases of splenomegaly, including conditions caused by malaria, kala-azar disease, leukemia, and anemia, or any unknown conditions, were treated by removing the spleen [ 12 ].

One of the first images of spleen, where it is marked as a separate organ with its own name ‘lien’, in “Anatomischer Atlas” by an Austrian anatomist Carl Toldt (1840–1920), (Berlin–Vienna 1906), the photo made by the author

The verification of rules according to which patients were selected for splenectomy was made thanks to the analyses of cases described in the medical literature. These analyses were made inter alia by Thornton (1886) [ 14 ], Wells (1888) [ 17 ], Abell (1933) [ 18 ], Lahey, and Norcross (1948) [ 19 ]. Of 500 splenectomies carried out to 1930 at the Mayo Clinic, there were only two cases of wandering spleen [ 20 ]. The analysis of 93 cases of wandering spleen with torsion of the pedicle made by Abell in 1933 showed that 88 cases occurred in women, mostly of an age ranging from 21 years to 40 years. The mortality rate among the operated patients amounted to 17.6 % [ 18 ].

Considering the high risk associated with splenectomy, clinical trials were carried out to decrease spleen size by pharmacological methods. In 1880 Goslin used hypodermic injection of ergotin into the enlarged spleen, and in 1883 Peiper injected fowler’s solution (a solution of potassium arsenite) directly into a leukemic spleen. However, the results of these treatments were not disclosed [ 8 ].

Following the example of a wandering kidney, which to the end of the nineteenth century any doctor without a special indication did not want to remove, in 1895 Ludwik Rydygier (1850–1920) operated to attach a wandering spleen to the peritoneum. This surgery, which he called splenopexy (following nephropexy), was based on fixation of the lower end of the spleen in a pocket made in the parietal peritoneum [ 21 ]. In the same year Hall carried out splenopexy by making a lumbar incision into the abdomen and fixing the spleen in it by means of tamponade [ 22 ]. One of the safest and easiest methods of splenopexy is Bardenheuer’s method, in which the spleen lies with its inferior pole in a retroperitoneal pouch; its pedicle is fixed to the peritoneal wound, and its body is suspended from the tenth rib.

Previous surgery course texts also taught splenorrhaphy, which is the suturing of the spleen for any purpose [ 23 ]. At the beginning of the twentieth century, splenopexy became a standard surgical procedure in the treatment of wandering spleen, unless torsion of the pedicle of a wandering spleen was diagnosed [ 24 ].

The impact of experimental physiology on spleen surgery

Attempts to explain the spleen’s importance for life were made by conducting physiological experiments on animals. In 1735 Deisch proved that dogs could live even though they had their spleens removed. He removed the spleen by means of various surgical techniques, which in his opinion would become useful in the clinical setting [ 8 ]. Special attention should be paid to pharmacological experiments done in the nineteenth century by Nivet (1838) and Pages (1846), who proved that the spleen decreased its size under the influence of alcohol and quinine. At the same time, similar experiments were done by Kűchenmeister, who used quinine and gentian violet to observe the spleen’s changes in size and the uptake of the dye. These more and more courageous experiments led to braver and braver conclusions. In 1857 John Harley announced that rats could live without a spleen and adrenal glands, and in 1866 Philipeaux presented the successful results of experiments related to transplanting a spleen taken from young animals and then replacing it in the abdominal cavity. The possibility of a spleen being transplanted was confirmed by Tizzoni in 1883 [ 8 ].

Such extraordinary spleen characteristics led Erwin Payr (1871–1946) to become interested in the spleen. In 1906 he presented to the German Surgeons’ Congress the results of experiments which referred to implanting fragments of the thyroid gland into a pouch made in the spleen into animals surgically deprived of thyroid; next, omentum was stitched over the splenic wound. Several days later the animals in the control group had their spleen with implemented fragments of thyroid gland removed, which resulted in tetanus and immediate death. Payr used these observations to treat a six-year-old girl diagnosed as a cretin and unsuccessfully treated her with thyroid tablets. He then took a sample of thyroid from the girl’s healthy mother and placed it in the girl’s spleen, which resulted in a considerable improvement in the child’s health. Similar experiments were carried out by William Halsted (1852–1922) [ 23 ].

These experiments were of clinical importance, yet determination of the function of the spleen remained unresolved (Fig.  2 ). This impasse was broken in 1933 when Jűrgen Aschoff (1818–1896) and Edmund Landau (1877–1938) published their work about the reticuloendothelial system. The work indicated anatomical and physiological spleen similarity to Kupffer cells (some macrophages) of the liver, the medullary tissue of the bones, the lymphatic glands, and the cortex of the adrenal gland. All these tissues are composed of similar cells, and after spleen removal they can take over the spleen’s functions, which provides an explanation for the mechanism of how an organism adapts to the results of splenectomy [ 25 ].

Aschoff and Landau’s work was of significant value for surgeons who for many years had been observing the fact that a relatively small amount of postoperative bleeding followed removal of the spleen. The examination of blood composition before and after splenectomy indicated a significant postoperative increase in the number erythrocytes and blood platelets. Spleen surgery turned out to be an underlying topic at the International Surgical Congress held in Rome in 1926. Discussions started about accessory spleens, which appeared to number several hundred in one patient, some of them the size of a walnut. Patients who underwent reoperation after splenectomy sometimes had a diagnosis of enlarged splenules; what is more, it was proved that splenules took over the functions of a removed spleen [ 25 ].

Medical technologies and spleen surgery

The introduction of medical technologies represented a watershed in surgery for wandering spleen, which is confirmed by analyses of the PubMed database. Before the era of such medical technologies as isotopic imaging and angiography, the diagnosis of the torsion of a wandering spleen was difficult. Hence, in 1925–1976, publications related to this issue came out on average 0.34 times a year. In 1977–1997 publications referring to wandering spleen torsion appeared on average 3.45 times a year, and by 1998–2011, when laparoscopy became the gold standard in wandering spleen surgery, publications increased to 8.42 times per year.

Twentieth century medicine described wandering spleen in patients ranging from 3 months to 82 years [ 7 ]. Accessory spleens occur in 10–15 % of the population. Generally, they are situated close to the splenic hilum, out of which 1–2 % are in the pancreatic tail, which is commonly mistaken on imaging studies for a neuroendocrine tumor [ 26 ] or neoplasm [ 27 ]. They are also accidentally discovered during surgical procedures conducted on kidneys, the peritoneum, or reproductive organs [ 28 ], yet they are most commonly found in the vicinity of the stomach [ 29 ]. Thus, surgery contributes to the progress of knowledge about spleen diseases.

At present wandering spleen is defined as an ectopic spleen that moved from its normal anatomical location because of congenital anomalies of the dorsal mesogastrium and the absence or malformation of normal splenic suspensory ligaments [ 30 ]. Various imaging techniques can be used to diagnose a wandering spleen. For example, plain radiography, barium enema, scintigraphy, grey-scale sonography, computed tomography (CT), Doppler ultrasonography, and angiography [ 31 , 32 ]. In cases where CT indicates the absence of the spleen in the left subphrenic space and finds a splenic-like mass in the abdomen or pelvis, diagnosis of a wandering spleen should be kept in mind [ 33 ].

The symptoms of abnormal spleen location with torsioned pedicle are splenomegaly and hemoperitoneum. Immediate splenectomy offers very good results in this a life-threatening condition, which occurs in no more than 0.2 % of cases [ 34 ]. Since 1998, laparoscopic exploration of the abdominal cavity offers the ultimate diagnostic confirmation [ 34 ], enables splenectomy with short postoperative hospital stay followed by a quick recovery. Imaging techniques can be useful in making the right diagnosis, especially angio-spiral CT and color-flow ultrasonography [ 35 ].

Since 2000, splenopexy has been carried out laparoscopically if the wandering spleen is healthy and noninfarcted, is of normal size, and has no signs of hypersplenism. The literature describes the sandwich technique, in which two meshes are used to sandwich the spleen [ 36 ].

To 2007 the literature indicates almost 500 cases of wandering spleen [ 36 ] diagnosed in patients ranging from 3 months to 82 years of age [ 7 ]. In recent years special attention has been paid to difficulties related to diagnosing wandering spleen in children [ 37 ], because clinical symptoms as well as laboratory test results are atypical. Thrombocytopenia is a rare complication of wandering spleen, usually accompanying torsion of an elongated splenic pedicle [ 38 , 39 ]. The diagnosis of a wandering spleen can sometimes be very difficult because of the similarity of the clinical symptoms to those of recurrent pancreatitis [ 40 ]. Moreover, medical technologies have elucidated the condition known as polysplenia, a complex congenital syndrome associating visceral heterotaxis and concomitant bilateral left-sidedness, when a spleen is divided into several splenules of the same size [ 41 ].

Wujastyk D (1998) The roots of ayurveda. Selections from Sanskryt medical writings. Penguin Books, London, p 276

Google Scholar  

Jackson SW (1978) Melancholia and the waning of the humoral theory. J Hist Med Allied Sci 33:367–376

Article   PubMed   CAS   Google Scholar  

Meek H (2009) Of wandering wombs and wrongs of women: evolving conceptions of hysteria in the Age of Reason. Engl Stud Can 35:105–128

Dietl J (1863) Wędrująca śledziona. Zapalenie otrzewnej. Śmierć (Wandering Spleen. Peritonitis. Death). Prz Lek 2:98–100

Duncan JW (1908) Prolapse of organs in mental conditions. Br Med J 69:478

Article   Google Scholar  

Panoralus D (1653) Intrologismorum pentecostae quinque, Rome, p 232

Lane TM, South LM (1999) Management of a wandering spleen. J R Soc Med 92:84–85

PubMed   CAS   Google Scholar  

Ricketts BM (1904) Surgery of the prostate, pancreas, diaphragm, spleen, thyroid and hydrocephalus. An historical review. Cincinatti, p. 95–130 www.archive.org

Henoch E (1874) Patologia i terapia szczegółowa. Choroby przyrządów jamy brzusznej (Pathology and detailed therapy. Diseases of abdomen). Redakcja Gazety Lekarskiej, Warsaw, p 220

Dietl J (1856) O ruchomej śledzionie, uwagi czerpane z oględzin pośmiertnych (About a wandering spleen from post mortem examination). Pamiętnik Towarzystwa Lekarskiego Warszawskiego 12:111–123

Zajaczkowski T (2010) Joseph Dietl (1804–1878). Innovator of medicine and his credit for urology. Centr Eur J Urol 63:62–67

Graham RB (1924) Renal and splenic lesions as factors in upper abdominal disease. Can Med Assoc J 14:20–26

Warbasse J (1894) On the surgery and physiology of the spleen. Ann Surg 20:205–227

Thornton KJ (1886) Two cases of splenectomy. Med Chir Trans 69:407–417

Martin A (1878) A successful case of splenectomy. Br Med J 39:191–192

Johnston GB (1908) Splenectomy. Ann Surg 48:50–65

Wells TS (1888) Remarks on splenectomy, with a report of a successful case. Med Chir Trans 71:255–263

Abell I (1933) Wandering spleen with torsion of the pedicle. Ann Surg 98:722–735

Lahey FH, Norcross JW (1948) Splenectomy: when is it indicated? Ann Surg 128:363–378

Salvin AA (1930) Ectopic spleen causing intestinal obstruction. Ann Surg 92:263–269

Rydygier L (1895) O przyszywaniu śledziony. Splenopexy (About sewing on of the spleen. Splenopexy). Prz Lek 34:65–66

Hall JB (1903) Splenopexy for wandering spleen. Ann Surg 37:481–485

Binnie JF (1912) Manual of operative surgery. Blakiston’s Son & Co., Philadelphia, pp 439–440 www.archive.org

Witz M, Witz L, Reina A et al (1985) Torsion of a wandering spleen. Postgrad Med J 61:181–182

Beer E (1928) Development and progress of the surgery of the spleen. Ann Surg 88:335–346

Hamada T, Isaji S, Mizuno S et al (2004) Laparoscopic spleen-preserving pancreatic tail resection for an intrapancreatic accessory spleen mimicking a nonfunctioning endocrine tumor: report of a case. Surg Today 34:878–881

Article   PubMed   Google Scholar  

Tozbikian G, Bloomston M, Stevens R et al (2007) Accessory spleen presenting as a mass in the tail of the pancreas. Ann Diagn Pathol 11:277–281

Weiand G, Mangold G (2003) Accessory spleen in the pancreatic tail—a neglected entity? A contribution to embryology, topography and pathology of ectopic splenic tissue. Chirurg 74:1170–1177

Bekheit M, Katri KM, Ezzat T (2012) Wandering hemi-spleen: laparoscopic management of wandering spleen in a case of polysplenia. Int J Surg Case Rep 3:151–154

Bouassida M, Sassi S, Chtourou MF et al (2012) A wandering spleen presenting as a hypogastric mass: case report. Pan Afr Med J 11:31

PubMed   Google Scholar  

Danaci M, Belet U, Yalin T et al (2000) Power doppler sonographic diagnosis of torsion in a wandering spleen. J Clin Ultrasound 28:246–248

Feroci F, Miranda E, Moraldi L et al (2008) The torsion of a wandering pelvic spleen: a case report. Cases J 1:149

Alshukry SM (2008) Splenic torsion. Oman Med J 23:287–288

Benevento A, Boni L, Dionigi G et al (2002) Emergency laparoscopic splenectomy for “wandering” (pelvic) spleen: case report and review of the literature on laparoscopic approach to splenic diseases. Surg Endosc 16:1364–1365

Corcione F, Caiazzo P, Cuccurullo D et al (2004) Laparoscopic splenectomy for the treatment of wandering spleen. Surg Endosc 18:554–556

Palanivelu C, Rangarajan M, Senthilkumar R et al (2007) Laparoscopic mesh splenopexy (sandwich technique) for wandering spleen. JSLS 11:246–251

Brown CW, Virgilio GR, Vazquez WD (2003) Wandering spleen and its complication in children: a case series and review of the literature. J Pediatr Surg 38:1676–1679

Moll S, Igelhart JD, Ortel TL (1996) Thrombocytopenia in association with a wandering spleen. Am J Hematol 53:259–263

Mirkes C, Ngyuen G, Cable C (2011) The wandering spleen: an unusual case of thrombocytopenia. J Blood Med 2:161–163

Lebron R, Self M, Mangram A et al (2008) Wandering spleen presenting as recurrent pancreatitis. JSLS 12:310–313

Merran S, Karila-Cohen P, Servois V (2007) CT anatomy of the normal spleen: variants and pitfalls. J Radiol 88:549–558

Download references

Author information

Authors and affiliations.

History of Medical Sciences, Poznan University of Medical Sciences, ul. Przybyszewskiego 37A, 61-111, Poznan, Poland

Anita Magowska

You can also search for this author in PubMed   Google Scholar

Corresponding author

Correspondence to Anita Magowska .

Rights and permissions

Open Access This article is distributed under the terms of the Creative Commons Attribution License which permits any use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited.

Reprints and permissions

About this article

Magowska, A. Wandering Spleen: A Medical Enigma, Its Natural History and Rationalization. World J Surg 37 , 545–550 (2013). https://doi.org/10.1007/s00268-012-1880-x

Download citation

Published : 13 December 2012

Issue Date : March 2013

DOI : https://doi.org/10.1007/s00268-012-1880-x

Share this article

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

  • Accessory Spleen
  • Enlarge Spleen
  • Interwar Period
  • Melancholia
  • Gentian Violet
  • Find a journal
  • Publish with us
  • Track your research

Rare Disease Day at NIH Logo

  • Browse by Disease

Wandering spleen

  • About the Disease
  • Getting a Diagnosis
  • Resources and Support

Disease at a Glance

Find your community, participating in clinical studies, about wandering spleen.

Many rare diseases have limited information. Currently, GARD aims to provide the following information for this disease:

  • Population Estimate: This section is currently in development.
  • Symptoms: This section is currently in development.
  • Cause: GARD does not currently have information about the cause of this disease.
  • Organizations: GARD is not currently aware of organizations specific to this disease.

When Do Symptoms of Wandering spleen Begin?

This section is currently in development. 

Patient organizations can help patients and families connect. They build public awareness of the disease and are a driving force behind research to improve patients' lives. They may offer online and in-person resources to help people live well with their disease. Many collaborate with medical experts and researchers. Services of patient organizations differ, but may include:

  • Ways to connect to others and share personal stories
  • Easy-to-read information
  • Up-to-date treatment and research information
  • Patient registries
  • Lists of specialists or specialty centers
  • Financial aid and travel resources

wandering spleen french

Patient Organizations

4 Organizations

Organization Name

Who They Serve

Helpful Links

Everylife foundation for rare diseases, people with.

Rare Diseases

United States

Genetic Alliance

Global genes, national organization for rare disorders.

Clinical studies are part of clinical research and play an important role in medical advances, including for rare diseases. Through clinical studies, researchers may ultimately uncover better ways to treat, prevent, diagnose, and understand human diseases.

wandering spleen french

What Are Clinical Studies?

Clinical studies are medical research involving people as participants. There are two main types of clinical studies:

  • Clinical trials determine if a new test or treatment for a disease is effective and safe by comparing groups receiving different tests/treatments.
  • Observational studies involve recording changes over time among a specific group of people in their natural settings.

Why Participate in Clinical Studies?

People participate in clinical trials for many reasons. People with a disease may participate to receive the newest possible treatment and additional care from clinical study staff as well as to help others living with the same or similar disease. Healthy volunteers may participate to help others and to contribute to moving science forward. To find the right clinical study we recommend you consult your doctors, other trusted medical professionals, and patient organizations. Additionally, you can use ClinicalTrials.gov to search for clinical studies by disease, terms, or location.

What if There Are No Available Clinical Studies?

ResearchMatch helps connect people interested in research studies  with researchers from top medical centers across the United States. Anyone from the U.S. can register with this free program funded by NIH. Researchers from participating institutions use the database to search for and invite patients or healthy volunteers who meet their study criteria to participate.

Join the All of Us Research Program!

The All of Us Research Program is inviting 1 million people from all backgrounds across the U.S. to help build one of the most diverse health databases in history. Researchers will use the data to learn how our biology, lifestyle, and environment affect health. This may one day help them find ways to treat and prevent diseases.

Learn about symptoms, cause, support, and research for a rare disease. 

Take steps toward getting a diagnosis by working with your doctor, finding the right specialists, and coordinating medical care.

Find resources for patients and caregivers that address the challenges of navigating life with a rare disease.

  • Reference: Access aggregated data from Orphanet at Orphadata . Orphanet is an online database of rare diseases and orphan drugs. Copyright, INSERM 1997.
  • Reference: OMIM is authored and edited at the McKusick-Nathans Institute of Genetic Medicine , Johns Hopkins University School of Medicine, under the direction of Dr. Ada Hamosh.
  • Reference: Human Phenotype Ontology Downloads  Kohler S, Gargano M. Matentzoglu N, et al., The Human Phenotype Ontology in 2021, Nucleic Acids Research, Volume 49, Issue D1, 8 January 2021, Pages D1207-D1217.
  • Reference: MedGen Data Downloads and FTP
  • Reference: MedLinePlus
  • Reference: Data from the Newborn Screening Code and Terminology Guide is available here. Downs SM, van Dyck PC, Rinaldo P, et al. Improving newborn screening laboratory test ordering and result reporting using health information exchange . J Am Med Inform Assoc. 2010 Jan-Feb; 17(1):13-8
  • The National Library of Medicine . (2023). Unified Medical Language System (UMLS) .
  • National Academies of Sciences, Engineering, and Medicine. (2015).  Improving Diagnosis in Health Care . Washington, DC: The National Academies Press.
  • U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion. (2016).  Health Literacy Online: A Guide for Simplifying the User Experience .

Last Updated: February 2024

U.S. flag

An official website of the United States government

The .gov means it’s official. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

The site is secure. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

  • Publications
  • Account settings
  • Advanced Search
  • Journal List
  • Int Med Case Rep J

Wandering spleen: Report of two cases

Ahmet turhan.

Bakirkoy Dr Sadi Konuk Research and Training Hospital, General Surgery Clinic, Istanbul, Turkey

Selin Kapan

Murat gonenc, mahmut dogan, ersan aygun.

Wandering spleen is a rare clinical condition which presents with a variety of symptoms with abdominal pain, abdominal mass, and acute abdomen. It may also remain silent until diagnosed by a routine imaging study. Treatment options may differ depending on the presenting clinical picture. Herein we present two cases of wandering spleen treated by splenectomy, with one of them admitted to our emergency clinic with torsion.

Introduction

Wandering spleen (WS) is a rare condition in which the spleen is located anywhere in the abdomen other than in its usual place; however, other terms are used to describe this clinical entity, including “displaced spleen”, “drifting spleen”, “floating spleen”, “pelvic spleen”, “splenic ptosis”, “splenoptosis”, “ectopic spleen”, and “dislocated spleen”. Although it remains enigmatic, the abnormal location of the spleen may be attributed to malformation or total agenesis of the splenic suspensory ligaments because of abnormal development of the dorsal mesogastrium. Therefore, the spleen may either drop into the abdominal cavity and be suspended only by extremely flexible ligaments, or float in the abdominal cavity suspended only by its pedicle. In addition, wandering spleen may occasionallyoccur as a result of weakening of the suspensory splenic ligaments by clinical processes such as trauma, pregnancy, and connective tissue diseases. Splenic torsion, the major complication of WS, was first mentioned in the German literature in 1885. Since then, WS and its clinical aspects have been fully identified, and WS has gradually become a well-known clinical entity. 1 , 2

In this article we report two cases of WS, one of whom presented with torsion. Written informed consent for publication was obtained from both patients.

Case report 1

A 21-year-old female was admitted to our emergency department with an acute abdomen. Apart from abdominal pain continuing for 36 hours, her medical history was insignificant. Physical examination revealed a giant mass located in the left abdominal quadrant, and generalized abdominal tenderness. Routine biochemical parameters were normal except for a moderate leukocytosis (16,500/mm³) and high C-reactive protein (CRP) (80 mg/L). Combined abdominal sonography and contrast-enhanced abdominopelvic computed tomography (CT) demonstrated the absence of a spleen in its normal position, with a 15 × 7 cm solid mass extending from the stomach to the pelvis in the left abdomen that was consistent with WS, and no contrast enhancement within the splenic parenchyma ( Figure 1 ). An urgent laparotomy revealed a significantly enlarged, infarcted WS secondary to splenic torsion of 540° ( Figures 2 and ​ and3). 3 ). The spleen was suspended by only its pedicle and a few peritoneal adhesions. Splenectomy was performed. The postoperative period was uneventful. The patient was discharged on the fourth postoperative day, to come back for vaccination two weeks later.

An external file that holds a picture, illustration, etc.
Object name is imcrj-3-019Fig1.jpg

Computed tomographic appearance of the torsioned wandering spleen.

An external file that holds a picture, illustration, etc.
Object name is imcrj-3-019Fig2.jpg

Torsioned spleen in laparotomy.

An external file that holds a picture, illustration, etc.
Object name is imcrj-3-019Fig3.jpg

Pelvic location of the spleen in computed tomography.

Case report 2

A 19-year-old female was seen in our outpatient clinic with enuresis and vague lower abdominal pain of six months’ duration. She had been treated for urinary tract infection several times within the previous three months. She had an abdominal sonogram because of persistence of her complaints. An enlarged WS of 16 × 6 cm in size extending from the left costal margin to the pelvis was demonstrated on abdominal sonography. Doppler scan showed patent splenic vessels. Contrast-enhanced abdominopelvic CT scan revealed an enlarged WS extending from the greater curvature to the urinary bladder, and a 3 × 2 cm mass consistent with an accessory spleen ( Figure 3 ). Because the spleen was enlarged, without any vascular compression, other causes of splenomegaly were investigated. Biochemical, microbiologic, and hematologic tests were all found to be normal. Surgical treatment was considered for management after hematological consultation. During exploratory laparoscopy, an enlarged WS with an accessory spleen at its hilum was found. There were dense adhesions between the WS and the urinary bladder. Given that the accessory spleen was evaluated to be adequate for further splenic function and the spleen was too enlarged to be replaced in its original position, laparoscopic splenectomy was preferred. The postoperative period was uneventful. The patient was discharged on the second postoperative day. The vaccination was deemed to be unnecessary because of the existing accessory spleen.

WS is a rarely seen birth defect with an incidence of < 0.2%, caused by an unusually long vascular pedicle which allows migration of the spleen from its normal anatomic position, and is most commonly diagnosed in young children as well as in women between the ages of 20 and 40 years. The first clinical description of WS, confirmed by autopsy, was by Johannes Van Horne, a Dutch physician, in 1667. 2 – 4

The clinical presentation of WS may be variable, from an asymptomatic patient to one with mild abdominal pain, signs of acute abdomen, or acute pancreatitis. The most common symptom of WS is abdominal pain caused by either splenic complications or mass effect. Splenic torsion, the most important complication of WS, may be either acute-complete or intermittent-incomplete. Acute-complete splenic torsion contributes to splenic ischemia in which the patient presents with acute abdominal symptoms, as did our first case. However, intermittent-incomplete splenic torsion may lead to venous congestion and subsequent hypersplenism. Therefore, such patients may present with intermittent or sustained vague abdominal pain, and may be found to have biochemical abnormalities because of hypersplenism, 5 , 6 as did our second case.

Patients with WS may also present with complications associated with other intra-abdominal organs, such as gastrointestinal obstruction secondary to splenic adhesions or a long splenic pedicle, pancreatic necrosis secondary to compression of the pancreatic tail, pancreatitis secondary to displacement of the pancreatic tail into the splenic hilum, bleeding from gastric varices secondary to splenic venous hypertension, and urinary symptoms secondary to compression of the ureters or the urinary bladder. Of note, WS may be asymptomatic with or without a palpable intra-abdominal mass, and is diagnosed incidentally. 7 – 10

The absence of spleen in its normal anatomic position and a presence of an intra-abdominal mass that has similar characteristics with the spleen are major determinants of diagnosis of WS by any imaging modalities utilized. Abdominal sonography and Doppler scan may not only demonstrate a WS but can also evaluate splenic blood flow to rule out a possible splenic torsion. 11 , 12 Contrast-enhanced abdominopelvic CT scan also provides information about the exact location of WS in relation to other intra-abdominal organs, and the viability of the spleen in the setting of a possible splenic torsion. 13 Other diagnostic imaging modalities include radionuclide scan and MRI. 14 Combined utilization of abdominal sonography and CT provided a correct diagnosis of WS in our both cases.

Symptomatic patients with WS warrant surgical treatment, but the management of asymptomatic WS remains controversial. However, many authors found a high rate of complications, splenic torsion in particular, associated with conservative treatment. 15 Since elective surgical treatment have the advantage of preservation of a viable spleen, surgical treatment seems to be the best option in asymptomatic WS.

Currently, there are two surgical treatment options for WS, ie, splenopexy and splenectomy. 16 – 19 Each procedure can be carried out by open or minimally invasive surgery. The major determinant of the treatment option should be viability of the spleen. Many authors recommend splenopexy in uncomplicated cases, especially in children; however, in cases of infarction due to splenic torsion, splenectomy seems to be the treatment of choice whether laparoscopic or open, depending on the patient’s situation, size of the spleen, and experience of the surgeon.

In conclusion, wandering spleen should be borne in mind for patients presenting with a palpable intra-abdominal mass causing acute or intermittent abdominal symptoms. Emergency intervention is mandatory in cases with torsion. Treatment is almost always surgical with either conventional or minimally invasive approaches.

Disclosures

The authors report no conflict of interest in this work.

IMAGES

  1. Wandering spleen

    wandering spleen french

  2. Wandering spleen

    wandering spleen french

  3. Cureus

    wandering spleen french

  4. Cureus

    wandering spleen french

  5. 44 Wandering Spleen

    wandering spleen french

  6. Cureus

    wandering spleen french

VIDEO

  1. wandering wanderland

  2. wandering wanderland

  3. unidad de inteligencia ciudadana

  4. ALERTA POR CAPTURA EN LA RUANA.. ZITACUARO A PUNTA DE MATRAZOS FIrma el X

COMMENTS

  1. Wandering spleen

    Cause. Though not a genetic disease, wandering spleen is often found at birth. It can occur in adults as the result of injuries and other similar conditions that cause the ligaments to weaken, such as connective tissue disease or pregnancy. [2] Wandering spleen (splenoptosis) predisposes the spleen to complications such as torsion, splenic ...

  2. Wandering Spleen

    A wandering spleen is a rare condition that can lead to significant health issues if not properly addressed. Understanding the symptoms, causes, and available treatment options is important for anyone diagnosed with this condition. With timely and appropriate medical care, individuals with a wandering spleen can lead healthy and active lives. ...

  3. Wandering spleen

    Clinical presentation. A wandering spleen can be an elusive diagnosis as its presentation is greatly variable and intermittent torsion can cause non-specific signs and symptoms. It can present as an asymptomatic or painful abdominal mass, intermittent abdominal pain, or as an acute abdomen (e.g. bowel obstruction, acute pancreatitis) 3,4,6.

  4. Wandering spleen: A rare entity and a diagnostic dilemma

    Wandering spleen is a rare clinical entity seen mainly in male infants or women of reproductive age group (20-40 years), in which spleen is present at an ectopic location. [ 5, 6] This has been attributed to the laxity of splenic ligaments which can be congenital or an acquired weakness due to hormonal changes or multiple pregnancies. [ 7, 8, 9 ...

  5. Wandering Spleen

    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. Fewer than 500 cases of wandering spleen have been reported in the medical literature.

  6. Wandering spleen in French

    Translation of "Wandering spleen" into French . Rate ectopique is the translation of "Wandering spleen" into French. Sample translated sentence: Preoperative diagnosis of wandering spleen is easy, thanks to the contribution of non-invasive imaging procedures. ↔ Le diagnostic préopératoire des rates voyageuses est facile grâce à l'apport de l'imagerie qui montre l'hypochondre gauche ...

  7. wandering spleen translation in French

    wandering. adj. [tribe] nomade. [minstrel, actor] ambulant (e) Translation English - French Collins Dictionary. "wandering spleen": examples and translations in context. She has a wandering spleen. Elle a une rate baladeuse. 2016 Wandering or migrating spleen is a rare anomaly which is usually described in children.

  8. Wandering spleen in children: multicenter retrospective study

    Wandering spleen in children is a rare condition. The diagnosis is difficult, and any delay can cause splenic ischemia. An epidemiologic, semiological, and surgical diagnosis questionnaire on incidence of wandering spleen in children was sent to several French surgical teams. We report the results of this multicenter retrospective study.

  9. Wandering Spleen in a Patient With Significant Medical History

    The clinical presentation of a wandering spleen is characterized mainly by unspecific acute symptoms, ranging from diffuse abdominal pain to left upper/lower quadrant and referred shoulder pain to asymptomatic. This has challenged accelerated medical care and impeded the acquisition of confirmatory diagnosis; therefore, increasing morbidity and ...

  10. Wandering spleen: a surgical enigma

    Wandering spleen (WS), is a rare clinical condition, with only about 500 cases reported worldwide and an incidence rate of 0.2% [1, 2]. One of the first documented descriptions of WS came from Dr Josef Dietl, a Polish clinician, who not only documented three cases between 1854 and 1863 but also described the laxity of splenic ligaments as the ...

  11. Wandering Spleen: A Rare Diagnosis with Variable Presentation

    Wandering spleen is a rare clinical condition found in less that 0.5% of splenectomies that is characterized by ectopic positioning of the spleen within the abdomen or pelvis . The first description of this entity is attributed to Van Horne, a Dutch physician in 1667 with confirmation by autopsy . Soleimani et al performed an extensive review ...

  12. Wandering Spleen: A Medical Enigma, Its Natural History and ...

    Introduction Wandering spleen is a rare condition in which the spleen is not located in the left upper quadrant but is found lower in the abdomen or in the pelvic region because of the laxity of the peritoneal attachments. Many patients with wandering spleen are asymptomatic, hence the condition can be discovered only by abdominal examination or at a hospital emergency department if a patient ...

  13. Wandering Spleen in a Patient With Significant Medical History

    French J, Austin C L, Sodade F E, et al. (Fe ... Wandering spleen is a rare medical condition that occurs due to developmental abnormality or acquired laxity of the ligaments that hold the spleen ...

  14. Wandering Spleen in a Patient With Significant Medical History

    Wandering spleen is a cause of acute surgical abdomen that can result in deleterious consequences if not identified or treated expeditiously. Often the challenge of accelerated medical care is increased by a delayed diagnosis due to the non-specific clinical presentation [ 1 ]. Symptoms can range from asymptomatic in some patients to diffuse ...

  15. Wandering spleen

    Symptoms of Wandering spleen may include englargement of the spleen (splenomegaly), abdominal pain, intestinal obstruction, nausea, vomiting, fever, and a lump in the abdomen or the pelvis. Some individuals with this condition do not have symptoms. Summary. Wandering spleen is a rare condition that occurs when the spleen lacks one or more of ...

  16. Wandering Spleen in a Patient With Significant Medical History

    A 22-year-old female who reported to the emergency department with a five-day persistent left upper quadrant and left lower quadrant (LLQ) abdominal pain, associated with nausea is presented, adding valuable teaching points about the treatment of wandering spleen in individuals with VACTERL anomalies. The clinical presentation of a wandering spleen is characterized mainly by unspecific acute ...

  17. Wandering Spleen: An Overview

    Wandering spleen (WS) is an uncommon congenital or acquired condition resulting from the absence or abnormal development of the spleen ligaments causing its outside position. WS has life-threatening complications ranging from torsion of the vascular pedicle to spleen infarction. In this paper, we report the use of open splenectomy in a female ...

  18. Wandering Spleen- A diagnostic Challenge: Case Report and Review of

    Wandering spleen or hypermobile spleen results from the elongation or maldevelopment of the spleen's suspensory ligaments. It is a rare clinical entity that mainly affects children. Among adults, it is most commonly found in females of active reproductive age. It may present as an asymptomatic mass in the abdomen, or it may present with ...

  19. Imaging Manifestations of Wandering Spleen With Torsion

    A wandering spleen (WS) or ectopic spleen is a rare clinical entity characterized by the spleen being located in the lower part of the abdomen or in the pelvic cavity rather than the normal anatomic site (i.e., the left hypochondrium) (. 1. ). The incidence of WS is less than 0.2% in all patients undergoing splenectomies (.

  20. Wandering Spleen

    Wandering Spleen. Alexander Wester, M.D., and Ivan Co, M.D. A 36-year-old woman presented with abdominal pain and nausea. Imaging performed 2 days apart showed the spleen in different locations ...

  21. Wandering Spleen: A Rare Case From the Emergency Department

    The wandering spleen can be asymptomatic and found incidentally on physical examination or radiological investigations. It may also present with acute abdominal pain due to a splenic infarct. Furthermore, as in our case, the wandering spleen may present with intermittent abdominal pain that may be related to intermittent torsion and spontaneous ...

  22. Wandering spleen; a rare clinical presentation of chronic pain with

    Wandering spleen is a rare clinical entity with a less than 0.2% reporting incidence rate, which the spleen can be found in a number of positions in the abdomen or pelvis, and this condition is a result of congenital malformation or agenesis of the splenic ligaments or ligamentous laxity due to trauma, pregnancy, and connective tissue diseases ...

  23. Wandering spleen: Report of two cases

    Wandering spleen is a rare clinical condition which presents with a variety of symptoms with abdominal pain, abdominal mass, and acute abdomen. It may also remain silent until diagnosed by a routine imaging study. Treatment options may differ depending on the presenting clinical picture. Herein we present two cases of wandering spleen treated ...