Medline ® Abstract for Reference 42
of 'Approach to acute abdominal pain in pregnant and postpartum women'
Wandering spleen--the challenge of ultrasound diagnosis: report of 7 cases.
Karmazyn B, Steinberg R, Gayer G, Grozovski S, Freud E, Kornreich L
J Clin Ultrasound. 2005;33(9):433.
PURPOSE: To summarize our experience with sonographic diagnosis of wandering spleen in children and assess for the typical sonographic findings of wandering spleen, complications, and possible diagnostic pitfalls.
METHODS: We identified all pediatric patients from 1998-2003 with a surgically confirmed diagnosis of wandering spleen. All sonographic examinations were reviewed for splenic position, size, echotexture, and parenchymal blood flow.
RESULTS: Seven children were identified with a mean age of 9.7 years (range 4.2-15.3 years). All presented with abdominal pain. Abdominal sonography, performed in all children demonstrated a low position of the spleen (n = 6), splenomegaly (n = 4), and absence of parenchymal flow in the three patients with splenic torsion and infarction. The diagnosis was made preoperatively via sonography in five children; three required repeated hospital admissions before the correct diagnosis was established. Complications occurred in five patients (gastric obstruction [n = 1], splenic infarction [n = 3], and recurrent pancreatitis [n = 1]).
CONCLUSION: The most specific sonographic finding for wandering spleen is low position of the spleen. However, if the spleen regains its normal or near-normal position, the diagnosis may be missed and the condition may recur, and result in complications.
Department of Pediatric Radiology, Schneider Children's Medical Center of Israel, Petah Tiqva, Israel.