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Laparoscopic splenopexy of a pediatric wandering spleen by creation of a retroperitoneal pocket.

Authors
  • Hedeshian, Mohir H
  • Hirsh, Michael P
  • Danielson, Paul D
Type
Published Article
Journal
Journal of laparoendoscopic & advanced surgical techniques. Part A
Publication Date
Dec 01, 2005
Volume
15
Issue
6
Pages
670–672
Identifiers
PMID: 16366881
Source
Medline
License
Unknown

Abstract

Wandering spleen is a rare condition in which the spleen is attached by a long, vascular pedicle and lacks its usual peritoneal attachments and supporting ligaments. This condition predisposes the spleen to torsion and infarction. We report the case of a 2-year-old boy with a history of intermittent abdominal pain and early satiety who presented with abdominal pain and severe gastric distention. A work-up including computed tomographic and ultrasonographic imaging suggested a wandering spleen. The diagnosis was confirmed during laparoscopy, and splenopexy was performed by anchoring the spleen in a retroperitoneal pocket in the left upper quadrant at the level of the tenth rib. To our knowledge, this is the first reported case of minimally invasive splenopexy for wandering spleen that involves the creation of a retroperitoneal pocket without the use of mesh. The authors believe that this is a safe and effective method that takes advantage of laparoscopy and avoids the risk of infection and complications associated with the use of synthetic material.

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