Wandering Spleen and Portal Hypertension: A Vicious Interplay
نویسندگان
چکیده
A 55-year-old woman presented with recurrent abdominal pain, a lump in her abdomen, and vomiting. In the previous 10 years, she required multiple hospital admissions for pain. Examination revealed pallor and a lump (20 cm 15 cm) extending from left hypochondrium to left iliac region. Labs showed hemoglobin 7.8 g/dL, platelet count 5,100 cells/mm, and serum protein/ albumin 6.7/3.4 g/dL; the rest of her blood parameters were normal. Ultrasound showed heterogeneous liver echo-texture, ascites, and massive splenomegaly. Esophagoduodenoscopy showed grade 2 esophageal varices. Ascetic fluid examination showed high serum ascites albumin gradient (SAAG). Etiological evaluation for chronic liver disease (CLD) was negative. Computed tomography (CT) showed a homogeneously enhanced, massively enlarged spleen in the left lower abdomen. The vascular pedicle was long, stretched, and appeared coiled (whirl sign), suggestive of torsion (Figure 1). Features of CLD with portal hypertension (PHT) were seen, including diffuse atrophy of liver parenchyma, dilated portal vein, prominent perigastric collaterals, and ascites. The patient showed symptomatic improvement with conservative treatment.
منابع مشابه
Mass at the splenic hilum: a clue to torsion of a wandering spleen located in a normal left upper quadrant position.
Wandering spleen is an extremely rare condition in which the spleen is lacking its normal ligamentous attachments and therefore can move to an ectopic position in the abdomen or pelvis. Wandering spleen predisposes the patient to life-threatening complications due to torsion of the spleen's vascular pedicle, with resulting splenic infarction, portal hypertension, and bleeding. Because of the no...
متن کاملVolvulus of a Wandering Spleen Presented With Portal and Splenic Venous Trombosis: A Case Report
Wandering spleen is a rare entity with the incidance of %0.2 (1), Here in we presented a 30-year-old woman with wandering spleen that leads to splenic volvulus and congestion with splenic venous thrombus and portal venous thrombus.
متن کاملطحال سرگردان Wandering Spleen
Wandering spleen is a rare condition , which is characterized by excessive mobility of spleen , due to absence or lack of its suspensor ligaments , in which the spleen migrate from it’s normal position (left upper abdomen) to lower abdomen , and even into pelvis. The case was a 94-year young woman , admitted to Imam Khomeini Hospital with colic abdominal pain , without any previous history...
متن کاملWandering Spleen with Venous Aneurysm as the Cause of Recurrent Abdominal Pain and Thrombocytopenia
متن کامل
Ectopic spleen with cirrhosis of liver.
Sir, Ectopic spleen is a rare anomaly with an incidence of less than 0.2%.1 The etiology may be congenital or acquired. A case of ectopic spleen diagnosed in a patient suffering from cirrhosis of liver with splenomegaly and to portal hypertension is reported. A 65-year old lady, the mother of six children, presented with gradual development of a lump in lower abdomen predominantly on the left s...
متن کامل