The asynchronous torsion of the main and accessory wandering spleens in an infant

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BACKGROUND: To diagnose the torsion of the wandering spleen in infants is a challenging task. Torsion of the wandering spleen in such population is an extremely rare case. Among children under one year of age, the wandering spleen is more common in boys (2.5:1). A total of 26 cases of torsion of an accessory spleen were described in the literature. Asymptomatic course of the disease before the first episode of spleen torsion occurs in 70% cases. No case of asynchronous torsion of the main and accessory wandering spleens are described in the literature.

CLINICAL CASE DESCRIPTION: This article describes a very rare clinical case of asynchronous torsion of the main and accessory wandering spleens in an infant. In the described case, basic clinical manifestations of the spleen torsion in an 8-month-old girl were typical for acute enteric infection. The child had laparoscopic splenectomy.

CONCLUSION: The present article describes challenges associated with the diagnostics of this pathology, important role of spiral computed tomography, efficacy of diagnostic laparoscopy and relaparoscopy as well as the efficacy of laparoscopic spleen resection in case of spleen necrosis in an infant.

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作者简介

Yuri Sokolov

Russian Medical Academy of Continuous Professional Education; Bashlyaevа Children’s City Clinical Hospital

Email: sokolov-surg@yandex.ru
ORCID iD: 0000-0003-3831-768X
SPIN 代码: 9674-1049
俄罗斯联邦, Moscow; Moscow

Sergey Stonogin

Bashlyaevа Children’s City Clinical Hospital

编辑信件的主要联系方式.
Email: svas70@mail.ru
ORCID iD: 0000-0003-3531-5849
SPIN 代码: 8552-6953

MD, Cand. Sci. (Medicine)

俄罗斯联邦, Moscow

Alexander Dziadchik

Bashlyaevа Children’s City Clinical Hospital

Email: dzyadchik@mail.ru
ORCID iD: 0000-0002-6751-3068
俄罗斯联邦, Moscow

Sergey Korovin

Russian Medical Academy of Continuous Professional Education; Bashlyaevа Children’s City Clinical Hospital

Email: korovinsa@mail.ru
ORCID iD: 0000-0002-8030-9926
俄罗斯联邦, Moscow; Moscow

Olga Korenkova

Bashlyaevа Children’s City Clinical Hospital

Email: olgha.korienkova@mail.ru
ORCID iD: 0000-0001-6569-7409
俄罗斯联邦, Moscow

参考

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2. Fig. 1. Ultrasound examination of the spleen. Lack of blood flow in the localized formation.

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3. Fig. 2. Intraoperative photo. Spleen pedicle is twisted by 720 degrees and is clearly visible.

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4. Fig. 3. Spleen macropreparation. Total necrosis in the removed spleen.

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5. Fig. 4. Spiral computed tomography of the abdominal organs. An accessory spleen is seen.

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6. Fig. 5. Intraoperative photo. Twisting of the accessory spleen in the left subdiaphragmatic space.

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版权所有 © Sokolov Y.Y., Stonogin S.V., Dziadchik A.V., Korovin S.A., Korenkova O.V., 2023

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