ID 106024
Author
Ishibashi, Hiroki Department of Pediatric Surgery, National Kagawa Children’s Hospital|Department of Pediatric Surgery and Pediatric Endoscopic Surgery, Tokushima University Hospital Tokushima University Educator and Researcher Directory KAKEN Search Researchers
Oshio, Takehito Department of Pediatric Surgery, National Kagawa Children’s Hospital
Sogami, Tomoko Department of Pediatric Surgery, National Kagawa Children’s Hospital
Nii, Akira Department of Pediatric Surgery, National Kagawa Children’s Hospital
Mori, Hiroki Department of Pediatric Surgery and Pediatric Endoscopic Surgery, Tokushima University Hospital Tokushima University Educator and Researcher Directory KAKEN Search Researchers
Shimada, Mitsuo Department of Pediatric Surgery and Pediatric Endoscopic Surgery, Tokushima University Hospital Tokushima University Educator and Researcher Directory KAKEN Search Researchers
Keywords
accessory spleen
torsion
situs inversus
Content Type
Journal Article
Description
We present an unusual case of acute abdomen caused by torsion of an accessory spleen with situs inversus in a child. A three-year-old girl was admitted to our hospital with an 11-day history of right flank pain with fever. Her medical history revealed an operation of coarctation of the aorta with situs inversus at one month of age. Physical examination revealed a right flank mass and tenderness. A contrast-enhanced CT scan showed a normally enhanced small spleen in the right upper quadrant and a 7.0×6.0×3.5 cm, hypodense, marginal enhancing mass in the right midabdomen adjacent to the intestine. An emergency laparotomy was decided upon with a preoperative diagnosis as an acute abdomen. During surgery, a mass was found under the greater omentum and two accessory spleens of 1.5 cm in diameter were found surrounding the main spleen. Several loops of bowel were adherent to the mass. The loops of bowel were dissected away. A pediculated congested mass was observed as an accessory spleen emerging from the greater omentum. The mass was twisted on its vascular pedicle and strangulated. The necrotic mass was removed and the postoperative recovery was uneventful. Though torsion of an accessory spleen is extremely rare, it should be considered in the differential diagnosis of acute abdomen in childhood.
Journal Title
The journal of medical investigation : JMI
ISSN
13431420
NCID
AA11166929
Volume
59
Issue
1-2
Start Page
220
End Page
223
Sort Key
220
Published Date
2012-02
EDB ID
FullText File
language
eng
TextVersion
Publisher
departments
Medical Sciences
University Hospital