SPLENOPTOSIS WANDERING SPLEEN

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).