Abdominal pain and wandering spleen in young children: the importance of an early diagnosis

J Pediatr Surg. 2009 Jul;44(7):1446-9. doi: 10.1016/j.jpedsurg.2009.02.062.

Abstract

Purpose: The aim of the study is to increase clinical awareness of torsion of wandering spleen (WS) in childhood and the need of a rapid diagnosis.

Methods: Four cases operated for torsion of WS are retrospectively reviewed. Ages at presentation were, respectively, 30 months, 5 years, 4 years, and 3 years, without sex preference. All subjects led a history of abdominal pain and a mass on physical examination.

Results: Torsion of WS should be suspected in any child presenting with acute abdomen. Moreover, in case of acute abdomen and intermittent abdominal pain, we suggest studying spleen position with ultrasound.

Conclusions: Ultrasonography with color Doppler is the best choice for diagnosis of torsion of WS. Computed tomography is a good complementary examination, but it needs to submit young patients to a general anesthesia and delays an emergency situation.

Publication types

  • Case Reports

MeSH terms

  • Abdominal Pain / diagnosis*
  • Abdominal Pain / etiology
  • Abdominal Pain / surgery
  • Child, Preschool
  • Diagnosis, Differential
  • Female
  • Humans
  • Male
  • Retrospective Studies
  • Splenectomy / methods*
  • Tomography, X-Ray Computed
  • Ultrasonography, Doppler, Color
  • Wandering Spleen / complications
  • Wandering Spleen / diagnosis*
  • Wandering Spleen / surgery