Wandering spleen with acute torsion' : a rare indication for splenectomy in an adult, complicated by postoperative splanchnic venous thrombosis and intestinal gangrene.

Geet Midha, Suraj Surendran, Myla Yacob, Inian Samarasam

BMJ case reports 2021 Feb 04

filter terms:

Wandering spleen (WS) is a hypermobile spleen that, due to the laxity of its ligaments, is prone to torsion. We report a case of a 45-year-old multiparous woman who presented with acute abdominal pain and a tender palpable mass. A contrast-enhanced computed tomography scan of the abdomen showed a WS with torsion. She underwent an emergency splenectomy and was discharged after an uneventful recovery. She was readmitted with splanchnic venous thrombosis and was managed with therapeutic low-molecular-weight heparin (LMWH) and discharged. Twenty days later, she presented with new-onset abdominal pain. She had not complied with LMWH as advised. The thrombosis had progressed, leading to small bowel gangrene, requiring resection and a stoma. Due to frequent metabolic disturbances, an early reversal of stoma was performed. She was lost to follow-up thereafter. This case highlights a rare indication for emergency splenectomy and one of its major postoperative complications. © BMJ Publishing Group Limited 2021. No commercial re-use. See rights and permissions. Published by BMJ.

Citation

Geet Midha, Suraj Surendran, Myla Yacob, Inian Samarasam. Wandering spleen with acute torsion' : a rare indication for splenectomy in an adult, complicated by postoperative splanchnic venous thrombosis and intestinal gangrene. BMJ case reports. 2021 Feb 04;14(2)