Laparoscopic splenectomy for infarcted splenoptosis in a child: a case report

Abstract

Wandering spleen is a rare birth defect characterized by absence or weakness of one or more of the ligaments that hold the spleen in its normal position. In this report we present the case of a 6-year-old girl admitted with diffuse abdominal pain, fever and emesis. Ultrasound and CT scan revealed the spleen was not found in its normal anatomical position. An enlarged spleen was identified displaced anteriorly and inferiorly at the L3 to L5-S1 level. Doppler ultrasonography of the splenic vessels revealed no blood flow consistent with infarction. Patient was taken to the operation room for a laparoscopic splenectomy. Treatment of choice for splenoptosis is surgery, either splenopexy or splenectomy. Decision to perform splenopexy or splenectomy depends on the viability of the spleen after detorsion. If the spleen appears infarcted, a splenectomy should be performed. Splenopexy is a reasonable option when the spleen appears viable after detorsion.