Wandering spleen: a medical enigma, its natural history and rationalization

Abstract

Introduction: Wandering spleen is a rare condition in which the spleen is not located in the left upper quadrant but is found lower in the abdomen or in the pelvic region because of the laxity of the peritoneal attachments. Many patients with wandering spleen are asymptomatic, hence the condition can be discovered only by abdominal examination or at a hospital emergency department if a patient is admitted to hospital because of severe abdominal pain, vomiting or obstipation.

Methods: This article aims to provide a historical overview of wandering spleen diagnostics and surgical treatment supplemented with an analyses of articles on wandering spleen included in the PubMed database.

Results: One of the first clinical descriptions of a wandering spleen was written by Józef Dietl in 1854. The next years of vital importance are 1877 when A. Martin conducted the first splenectomy and in 1895 when Ludwik Rydygier carried out the first splenopexy to immobilize a wandering spleen. Since that time various techniques of splenectomy and splenopexy have been developed.

Conclusions: Introducing medical technologies was a watershed in the development and treatment of wandering spleen, which is confirmed by the PubMed database. Despite the increased number of publications medical literature shows that a wandering spleen still remains a misdiagnosed condition, especially among children.

Fig. 1

Józef Dietl (1804–1878), a Polish physician who described one of the first cases of a wandering spleen in a child (by courtesy of the Polish National Digital Archives)

Fig. 2

One of the first images of spleen, where it is marked as a separate organ with its own name ‘lien’, in “Anatomischer Atlas” by an Austrian anatomist Carl Toldt (1840–1920), (Berlin–Vienna 1906), the photo made by the author