wandering spleen


Also found in: Dictionary, Thesaurus, Encyclopedia, Wikipedia.

float·ing spleen

a spleen that is palpable because of excessive mobility from a relaxed or lengthened pedicle, rather than because of enlargement.

spleen

(splen) [Gr. splen]
A dark red, oval lymphoid organ in the upper left abdominal quadrant posterior and slightly inferior to the stomach; on the inferior side is the hilum, an indentation at which the splenic vessels and nerves enter or exit. The spleen is surrounded by an outer capsule of connective tissue from which strands of connective tissue (trabeculae) extend into the soft pulp (functional tissue), dividing the spleen into compartments.

The white pulp, composed of lymphocytes and follicles, forms sheaths around arterial vessels and collects in larger nodules containing germinal centers. The red pulp contains vascular sinuses and sinusoids with highly permeable walls, and spongelike splenic cords filled with macrophages and dendritic cells. The spleen is part of the mononuclear phagocytic system and its removal (splenectomy), though compensated for by the lymph nodes and liver, decreases immune function and may place the patient at increased risk for infection, esp. from Streptococcus pneumoniae and Haemophilus influenzae.

Function

In the embryo, the spleen forms both red and white blood cells; after birth, only lymphocytes are created except in severe anemia, when production of red blood cells may be reactivated. Blood enters via the splenic artery and passes through progressively smaller arterial vessels; foreign antigens are trapped in the white pulp, initiating proliferation of antigen-specific lymphocytes and antibodies. The arterioles terminate in the red pulp, where macrophages remove cell debris, microorganisms, and cells that are old, damaged, abnormal, or coated with antibody.

The vascular capacity of the spleen, 100 ml to 300 ml, is an average of 4% of the total blood, and the spleen may contain 30% of the total platelets. In stressful situations, sympathetic impulses stimulate constriction of the venous sinuses, forcing most of the splenic blood into circulation. If the spleen is enlarged (splenomegaly), its vascular capacity increases dramatically, and increased contact with macrophages may cause anemia, leukopenia, and thrombocytopenia. Removal of the spleen may be necessary in patients with thrombocytopenia. Many disorders cause splenomegaly, including portal hypertension (e.g., in cirrhosis), heart failure, and certain infections. Primary disorders of the spleen, however, are rare. See: lymphatic system for illus.; asplenia syndrome; germinal center

accessory spleen

Splenic tissue found outside the main bulk of the organ, usually but not always within the peritoneal cavity. If the patient is asymptomatic, the accessory spleen may be found only as an incidental mass on an abdominal scan; alternatively, the condition may exacerbate certain illnesses (e.g., immune thrombocytopenic purpura).

floating spleen

An enlarged movable spleen that is not protected by the ribs. Synonym: splenectopia

lardaceous spleen

An enlarged spleen resulting from fatty tissue.
See: amyloid degeneration

sago spleen

A spleen having the appearance of grains of sago.

wandering spleen

A dislocated floating spleen.
Mentioned in ?
References in periodicals archive ?
In addition to the developmental problems, severe abdominal wall laxity resulting from previous abdominal surgery, pregnancy, trauma, severe muscular atrophy or even splenomegaly may also induce ligament laxity, which finally leads to a wandering spleen (1,2).
A wandering spleen is most common between 1 and 12 years of age among pediatric patients, more frequent in boys under one year of age and in girls over one year of age (3,4).
Some cases of a wandering spleen accompanying congenital anomalies, such as prune-belly syndrome, renal agenesis, gastric volvulus, and congenital diaphragmatic hernia have been reported (3,4).
Laboratory findings of wandering spleen are non-specific, except leukocytosis in some cases (5).
A wandering spleen can be acquired form, in which hormonal effects of pregnancy and abdominal wall laxity are proposed as determining factors.
A wandering spleen usually presents between the ages of 20 and 40 years, being more common in women.
In patients with wandering spleen, torsion can be intermittent causing symptoms of mild abdominal pain related to splenic congestion or it can be acute and severe, leading to rapid splenic necrosis.
Wandering spleen with or without volvulus is a rare clinical entity.
CT is the preferred modality for diagnosing a wandering spleen when torsion is suspected clinically or is based on imaging studies.
CT signs of a wandering spleen with acute torsion include: absence of spleen anterior to the left kidney and posterior to the stomach; a lower abdominal or pelvic mass, with homogeneous /heterogeneous splenic parenchyma and an attenuation value less than that of normal splenic tissue; whorled appearance of splenic vessels and surrounding fat; and the presence of secondary findings such as ascites and necrosis of the pancreatic tail.
Previously, splenectomy was the standard recommended treatment for wandering spleen, with or without the presence of torsion.
Wandering spleen with torsion of vascular pedicle: early diagnosis with multiplaner reformation technique of multislice spiral CT.