SPLENOPTOSIS WANDERING SPLEEN
Category: Pediatric Surgery
Abstract : Splenoptosis (Wandering spleen) is a rare congenital fusion anomaly of the dorsal mesogastrium of
the spleen that results in failure and laxity of its normal attachment to the diaphragm, retroperitoneum and
colon. Relatively more common in children than adults, and females outnumber males. The child presents with
an asymptomatic mass (splenomegaly), mass and subacute gastrointestinal complaints
Splenoptosis (Wandering spleen) is a rare congenital fusion anomaly of the dorsal mesogastrium of
the spleen that results in failure and laxity of its normal attachment to the diaphragm, retroperitoneum and
colon. Relatively more common in children than adults, and females outnumber males. The child presents with
an asymptomatic mass (splenomegaly), mass and subacute gastrointestinal complaints or with acute
abdominal symptoms.
These are the result of torsion of the pedicle, ischemia and splenic sequestration. 50%
of spleens are lost to acute ischemia from torsion. Other complications are: pancreatitis, hypersplenism and
cyst formation. Lab tests are nonspecific, but may occasionally reveal evidence of hypersplenism or functional
asplenia. Diagnosis needs a high index of suspicion, and is achieved with: Ultrasound, CT, and Scintigram.
Management consists of splenectomy for frank splenic infarct, or splenopexy for viable organs. Splenopexy is
achieved by creating an extraperitoneal pocket or wrapping the spleen in absorbable mesh and anchoring to
the retroperitoneum (splenic nood).
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