NADİR GÖRÜLEN BİR AKUT KARIN SEBEBİ: GEZİCİ DALAK TORSİYONU

Gezici dalak, dalağın peritoneal bağlarındaki gevşeklik nedeniyle normal yeri dışında bulunmasışeklinde görülen nadir bir durumdur. Hastaların çoğu asemptomatiktirler. Bu yüzden çoğunluklatanı başka bir sebeple yapılan karın ameliyatı esnasında konulsa da nadiren hastalar akut karıntablosu ile de acile başvurabilirler.Bu olgu sunumunda uzun zamandır olan müphem sol alt kadran ağrısının iki gündür belirginleşmesi ile acile başvuran 26 yaşında kadın hasta takdim edilmiştir. Ameliyat öncesi yapılan tomografide sol alt kadranda tamamına yakını iskemik hal alan dalak ile uyumlu görünüm saptananhasta acil şartlarda ameliyat edilmiş ve splenektomi yapılmıştır.Şikayetleri düzelen hasta ameliyat sonrası 3. gün sorunsuz şekilde taburcu edilmiştir.Karında kitle palpe edilen, kronik tekrarlayıcı karın ağrısı olan hastalarda gezici dalak, özellikleakut karın tablosu ile başvuranlarda ise gezici dalak torsiyonu olabileceği akılda tutulmalıdır.Dalak enfarktı gelişmemiş olan ve özellikle genç yaştaki vakalarda dalak koruyucu yöntemlertercih edilmelidir.

A Rare Cause of Acute Abdomen: Torsion of the Wandering Spleen

Wandering spleen is a rare condition in which the spleen is located in another place than its normal location because of the weakening of the peritoneal ligaments of the spleen. Most of the patients are asymptomatic. Therefore, patients may rarely present to emergency departments with acute abdomen although such patients are mostly diagnosed during abdominal surgical procedures performed for other reasons. We hereby present the case of a 26-year-old female patient who presented to the emergency department because of the deterioration of an obscure long-lasting pain in the lower left quadrant within the last two days. The patient’s pre-operative tomography showed an image concordant with an almost completely ischemic spleen in the lower left quadrant and she was taken into emergency surgery to perform splenectomy. The patient whose complaints improved was discharged on the post-operative 3rd day without any problems. Physicians should take wandering spleen into consideration in patients with palpable abdominal mass and chronic recurrent abdominal pain and torsion of the wandering spleen especially in patients who present with acute abdomen. Spleen-protective methods should be preferred especially for young patients and patients without splenic infarct and.

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