Torsion of Wandering Spleen in Situs Inversus Totalis

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  • Matsushita Kohei
    Department of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of Medicine
  • Inoue Mikihiro
    Department of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of Medicine
  • Koike Yuhki
    Department of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of Medicine
  • Otake Kohei
    Department of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of Medicine
  • Uchida Keiichi
    Department of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of Medicine
  • Miki Chikao
    Department of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of Medicine
  • Kusunoki Masato
    Department of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of Medicine

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Other Title
  • 完全内臓逆位症に合併した遊走脾茎捻転症の1例
  • 症例報告 完全内臓逆位症に合併した遊走脾茎捻転症の1例
  • ショウレイ ホウコク カンゼン ナイゾウ ギャクイショウ ニ ガッペイ シタ ユウソウヒケイ ネンテンショウ ノ 1レイ

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Abstract

This is a case report of an 11-year-old male with torsion of wandering spleen in situs inversus totalis. At birth, he was diagnosed with situs inversus totalis, double outlet right ventricle, and common ventricle. This time, he suffered from the right upper quadrant pain with localized tenderness. Plain CT revealed a small round calcification like a fecalith in the right upper abdomen, and emergency surgery was performed on the preoperative diagnosis of acute appendicitis with intestinal malrotation. At laparotomy, though the appendix was normal, torsion of inverted spleen without suspensory ligaments resulting in infarction was detected. Blood supply was not restored by detorsion and splenectomy was performed. Wandering spleen is a rare form of developmental anomaly arising from either a congenital or acquired laxity of the suspensory ligaments of the spleen and can be a cause of torsion. In this case, coexisting situs inversus totalis and malrotation made it difficult to diagnose accurately. In situs inversus totalis, complicating splenic torsion is extremely rare, but it is necessary to consider the possibility of this entity.

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