çocukta akut batın; wandering pelvik spleen torsiyonu

Wandering spleen çok yaygın olmayan hayatı tehdit eden bir klinik tablodur. Karın ağrısı, hassasiyet ve karın orta hatta kitlesi olan 11 yaşında kız hasta opere edildi. Preoperatif dönemde yapılan bilgisayarlı tomografide uzun pedikülü etrafında saat yönünde 720° torsiyone olmuş, büyük, iskemik gezgin dalak tespit edildi. Detorsiyon sonrası kanlanma düzelmedi ve splenektomi yapıldı.

Anahtar Kelimeler:

Wandering spleen, dalak torsiyonu, akut karın

Torsion of a Wandering Pelvic Spleen; Acute Abdomen in a Child

Wandering spleen is an uncommon clinical entity. Acute splenic torsion of wandering spleen is a potentially fatal surgical emergency case, and its correct and early identification continues to represent a challenge especially in children. A 11 years old girl was taken to the operative room for an explorative laparotomy due to abdominal pain, tenderness, and a midabdominal mass. Preoperative computerise tomography showed a torsion of an enlarged wandering pelvic spleen which was in a serious ischemic suffering due to a 720 degrees clock torsion around its exceptionally long pedicle. Splenectomy has been the treatment for symptomatic wandering spleen as in our case.

Keywords:

Wandering spleen; spleen torsion; acute abdomen,

PDF

___

Ben Ely A, Zissin R, Copel L, et al. The wandering spleen: CT findings and possible pitfalls in diagnosis. Clin Radiol 2006;61(11):954-8.
Taori K, Ghonge N, Prakash A. Wandering spleen with torsion of vascular pedicle: early diagnosis with multiplaner reformation technique of multislice spiral CT. Abdom Imaging 2004;29(4):479-81.
Nemcek AA Jr, Miller FH, Fitzgerald SW. Acute torsion of a wandering spleen: diagnosis by CT and duplex Doppler and color flow sonography. AJR Am J Roentgenol. 1991 Aug;157(2):307-9.
Sheflin JR, Lee CM, Kretchmar KA: Torsion of wandering spleen and distal pancreas. AJR Am J Roentgenol 1984, 142:100-101
Herman TE, Siegel MJ: CT of acute splenic torsion in children with wandering spleen. AJR Am J Roentgenol 1991, 156:151-153.
Swischuk LE, Williams JB, John SD.Torsion of wandering spleen: the whorled appearance of the splenic pedicle on CT. Pediatr Radiol 1993 23:476– 477
Dillman JR, Strouse PJ.. The "wandering" spleen. Pediatr Radiol. 2009 10.1007/s00247-009-1376-5
Ida Di Crosta, Alessandro Inserra, Carlos Pueyo Gil, Mara Pisani, Antonio Ponticelli. Abdominal pain and wandering spleen in young children: the importance of an early diagnosis J Ped. Surgery (2009) 44, 1446–1449
Soleimani M, Mehrabi A, Kashfi A, Fonouni H, Büchler MW, Kraus TW: Surgical treatment of patients with wandering spleen: report of six cases with a review of the literature. Surg Today 2007, 37(3):261-9.