Erol KİSLİ, Nuriye LOBUT, REMZİ KIZILTAN, Çetin KOTAN, Muammer KARAAYVAZ

Akut karnın nadir bir nedeni olarak gezici dalak torsiyonu: Olgu sunumu

Dalak diyaframın sol tarafında peritoneal bağlarla oldukça iyi fikse olmuş bir organdır. Henüz bilinmeyen patolojisi ile gezici dalak oldukça nadir görülen bir klinik durumdur. Gezici dalak en sık alt karı n veya pelvise yerleşir. şüphelenilmezse tanı koyabilmek zordur. Sıklıkla dalak alt karında palpe edilebilir. Nadir olgularda splenik vasküler pedikül torsiyona uğradığında semptomatik olabilir ve splenektomi yapılmalıdır. Bu yazıda, akut karna yol açmış gezici dalak torsiyonu nedeniyle splenektomi yaptığımız olgu literatür eşliğinde değerlendirilmiştir.

Anahtar Kelimeler:

Karın, akut, Gezici dalak, Tedavi sonucu, Splenektomi, Kadın, Erişkin, Torsiyon anomalisi

Torsion of wandering spleen as a rare cause of acute abdomen: A case report

Spleen is well fixed on the left side of diaphragm with peritoneal bonds. Wandering spleen is a rare medical condition with its yet unknown pathogenesis. Wandering spleen is mostly located in lower abdomen or pelvis. Diagnosis is difficult if it is not suspected. Spleen can often be palpated in lower abdomen. Rarely it can be symptomatic when there is torsion of splenic vascular pedicle and splenectomy should be performed in this case. We report and evaluate a case who underwent splenectomy due to torsion of wandering spleen resulted in acute abdomen with a review of relevant literature.

Keywords:

Abdomen, Acute, Wandering Spleen, Treatment Outcome, Splenectomy, Female, Adult, Torsion Abnormality,

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1. Seymour I. Schwartz. Principles of surgery. USA. McGraw-Hill Companies; 1999. Geçim IE. Cerrahinin ilkeleri. Çeviri editörü: Karayalçın K. Dalak. 7. Baskı. Baran Ofset Matbaacılık. 1999. s. 1533.
2. Sarria Octavio de Toledo L, Cozcolluela Cabrejas R, Garcia Asensio S, Martinez-Berganza T. Wandering spleen associated to inflammatory pseudotumor. Radiologia 2006;48:173-6.
3. Lin CH, Wu SF, Lin WC, Chen AC. Wandering spleen with torsion and gastric volvulus. J Formos Med Assoc 2005;104:755-8.
4. Safioleas MC, Stamatakos MC, Diab AI, Safioleas PM. Wandering spleen with torsion of the pedicle. Saudi Med J 2007;28:135-6.
5. Befikadu S, Gudu W, Abseno N. Torsion of a pelvic wandering spleen as a cause of acute abdomen in a woman: a case report and review of the literature. Ethiop Med J 2004;42:53-61.
6. Moran JC, Shah U, Singer JA. Spontaneous rupture of a wandering spleen: case report and literature review. Curr Surg 2003;60:310-2.
7. 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;29:479-81.
8. Sheflin JR, Lee CM, Kretchmar KA. Torsion of wandering spleen and distal pancreas. AJR Am J Roentgenol 1984;142:100-1.
9. 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;157:307-9.
10. Greig JD, Sweet EM, Drainer IK. Splenic torsion in a wandering spleen, presenting as an acute abdominal mass. J Pediatr Surg 1994;29:571-2.
11. Herman TE, Siegel MJ. CT of acute splenic torsion in children with wandering spleen. AJR Am. J Roentgenol 1991;156:151-3.
12. Sodhi KS, Saggar K, Sood BP, Sandhu P. Torsion of a wandering spleen: acute abdominal presentation. J Emerg Med 2003;25:133-7.
13. Herman TE, Siegel MJ. CT of acute splenic torsion in children with wandering spleen. AJR Am J Roentgenol 1991;156:151-3.
14. Desai DC, Hebra A, Davidoff AM, Schnaufer L. Wandering spleen: a challenging diagnosis. South Med J 1997;90:439-43.
15. Cohen MS, Soper NJ, Underwood RA, Quasebarth M, Brunt LM. Laparoscopic splenopexy for wandering (pelvic) spleen. Surg Laparosc Endosc 1998; 8:286-90.
16. Masamune A, Okano T, Satake K, Toyota T. Ultrasonic diagnosis of torsion of the wandering spleen. J Clin Ultrasound 1994;22:126-8.