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Spleen
Published in Brice Antao, S Irish Michael, Anthony Lander, S Rothenberg MD Steven, Succeeding in Paediatric Surgery Examinations, 2017
Zachary Kastenberg, Sanjeev Dutta
Scenario 3 depicts a case of a wandering spleen. Wandering spleen is a rare condition caused by the absence of the avascular peritoneal attachments allowing the spleen to sit low in the abdomen and rotate around the narrow hilar pedicle. Wandering spleen occasionally presents as acute torsion, as in this question, and requires emergency operative intervention with splenopexy or splenectomy if infarction is present.
Test Paper 7
Published in Teck Yew Chin, Susan Cheng Shelmerdine, Akash Ganguly, Chinedum Anosike, Get Through, 2017
Teck Yew Chin, Susan Cheng Shelmerdine, Akash Ganguly, Chinedum Anosike
Myelofibrosis causes splenomegaly and therefore make splenic detection easier. All of the other options provided are potential causes of a non-visualised spleen. Polysplenia syndrome (also known as bilateral left-sidedness) is, as the name suggests, actually associated with multiple spleens, but these are usually in the wrong place (in addition to a vast array of other intra-abdominal anomalies). A wandering spleen relates to the condition where the spleen is attached to an abnormally long and mobile pedicle, which means that the spleen can be found in places other than in the left upper quadrant.
Left lower quadrant pain: an unlikely diagnosis in a case of acute abdomen
Published in Journal of Community Hospital Internal Medicine Perspectives, 2018
Jennifer Williams, Shumona Ima, Charles Milrod, Mahesh Krishnamurthy
LLQ pain is an extremely uncommon presentation of splenic infarction. In the literature, the most common spleen-related cause of LLQ pain is wandering spleen, which is a condition where the suspensory ligaments of the spleen are weakened or lost, allowing the spleen to move away from the left upper quadrant to anywhere within the abdominal cavity [3]. Not commonly described in the literature is a case of LLQ pain caused by massive splenomegaly. Neither splenic infarct nor lymphoma would have been on the differential diagnosis for LLQ pain if not for the initial CT scan in the emergency department, which showed the infarcted portion of the spleen. As is often the standard of care for severe acute abdominal pain, imaging will be obtained in these situations and the search for the cause of splenic infarct can begin. We hope this case will encourage keeping lymphoma high on the differential diagnosis of any splenic infarct.