Abdul Sattar Memon, Faisal Ghani Siddiqui, Roshan Shaikh.
Wandering Spleen.
J Coll Physicians Surg Pak Jan ;12(10):636-8.

A case of wandering spleen in a 30-year-old male is presented which had evaded clinical diagnosis and was discovered on exploratory laparotomy.

Case Report: A 30-year-old male labour presented with intermittent dull dragging pain since three years in the lower abdomen radiating towards left hypochondrium. In the last two months, the pain had increased in severity and frequency. He had no other complaints. On examination, a large ill-defined mass was palpable in the lower abdomen apparently arising from the pelvis. The mass was non-tender, mobile and astonishingly, never noticed by the patient before. Abdominal ultrasound revealed a 15 x 20 cms solid mass in the pelvis but failed to suggest any specific origin of the lump. The biochemical tests were within normal limits. With no definite clinical diagnosis in hand, an exploratory laparotomy was planned. The abdomen was opened through a right paramedian incision. A huge spleen with definite notch was found in the pelvis. It had an elongated pedicle extending into the left hypochondrium. There were no other intraabdominal pathologies. Partly due to the huge size of the spleen, (approximately 18 x 22 cms) and partly because preservation of spleen was deemed technically difficult, it was decided to proceed with splenectomy. The abdomen was closed primarily. There was no intra- or postoperative complication. The patient was given pneumococcal vaccine (pneumovax®) and was discharged on the fifth postoperative day. Follow-up at 2 and 10 months indicated that he was asymptomatic with complete resolution of symptoms.

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