'Wandering spleen with acute torsion' : a rare indication for splenectomy in an adult, complicated by postoperative splanchnic venous thrombosis and intestinal gangrene.
Geet MidhaSuraj SurendranMyla YacobInian SamarasamPublished in: BMJ case reports (2021)
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.
Keyphrases
- abdominal pain
- computed tomography
- contrast enhanced
- small bowel
- liver failure
- magnetic resonance imaging
- diffusion weighted
- respiratory failure
- positron emission tomography
- public health
- emergency department
- dual energy
- magnetic resonance
- drug induced
- aortic dissection
- healthcare
- diffusion weighted imaging
- patients undergoing
- venous thromboembolism
- image quality
- hepatitis b virus
- growth factor
- case report
- emergency medical
- extracorporeal membrane oxygenation