'Wandering spleen with acute torsion' : a rare indication for splenectomy in an adult, complicated by postoperative splanchnic venous thrombosis and intestinal gangrene. Issue 2 (4th February 2021)

• Record Type: Journal Article
• Authors: Midha, Geet; Surendran, Suraj; Yacob, Myla; Samarasam, Inian
• Is Part Of: BMJ case reports. Volume 14:Issue 2(2021)
• Publication Date: 2021-02-04
• Subjects: gastrointestinal surgery -- general surgery -- emergency medicine -- radiology -- portal vein; Medicine -- Case studies -- Periodicals; 610.5
• DOI: 10.1136/bcr-2020-238647
• Languages: English
• ISSNs: 1757-790X

Abstract

Abstract : 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.