Successful surgical treatment of spleen swirling

Abstract

Introduction. The wandering spleen is a rare developmental anomaly characterized by congenital insufficiency of the ligamentous apparatus, a long vascular pedicle, dystopia, and abnormal mobility of this organ. To date, about 500 cases of the vagus spleen in children and adults have been described in the world literature. In most patients, spleen volvulus is asymptomatic until the first episode of torsion. Ultrasound diagnostics with the determination of blood flow in the vessels of the spleen, spiral computed tomography without and with contrast and magnetic resonance imaging, as well as the data of an objective examination, are of great importance in the diagnosis of pathology. It should be emphasized that due to the high risk of developing serious complications, surgical intervention is indicated even in children with asymptomatic course of this disease. Observations of spleen volvulus in adults requiring emergency surgery are rare, which is of particular clinical interest.
Materials and methods. A 36-year-old patient was admitted to the hospital for emergency indications. As a result of the examination, the diagnosis was established: spleen dystopia, spleen volvulus. An emergency surgery was performed for spleen volvulus - diagnostic laparoscopy, laparotomy, organ detorsion and splenopexy of the latter in the retroperitoneal space of the left lateral canal. The postoperative period was smooth, the wounds healed by primary intention.
Conclusion. Timely surgical intervention made it possible to perform organ-preserving surgery and prevent further relapses of spleen volvulus.