1/2. Torsion of a wandering spleen with whorled appearance of the splenic hilum in CT scan.An eight-year-old boy admitted for acute abdominal pain was diagnosed to have torsion of the spleen (TS) based on contrast enhanced computerised tomography (CECT) of the abdomen. CECT showed whorled appearance in the splenic hilum. Whorl sign' refers to the presence of a twisted splenic pedicle intermingled with fat, resulting in alternating circular bands of radiodensity and radiolucency and is considered diagnostic of TS. This is the fourth reported case of whorl sign in children with TS and the first from malaysia.- - - - - - - - - - ranking = 1keywords = abdomen (Clic here for more details about this article) |
2/2. Pediatric wandering spleen successfully treated by laparoscopic splenopexy.wandering spleen is a rare clinical condition associated with a high incidence of splenic torsion and infarction. The preferred treatment is splenopexy to reposition the spleen in the left upper quadrant of the abdomen. We report the case of a 12-year-old girl who presented with intermittent abdominal pain. An abdominal sonography was diagnostic of wandering spleen. The patient was successfully treated by laparoscopic splenopexy. The spleen was repositioned in the left upper quadrant and fixed to the posterior abdominal wall by a mesh patch attached by staples. To reinforce the splenopexy we created an additional support by plicating the phrenocolic ligament and suturing it to the lateral abdominal wall, making a pouch for the inferior pole of the spleen. The postoperative course was rapid and uneventful. A normal spleen position was verified by radionuclide scans at 3 days and 6 months postoperatively. Laparoscopic splenopexy is an excellent option for organ-preserving treatment in wandering spleen.- - - - - - - - - - ranking = 1keywords = abdomen (Clic here for more details about this article) |