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Floating spleen with chronic torsion of the pedicle causing splenomegaly and secondary hypersplenism

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Author(s): Čolović Radoje B. | Bošković Darinka V. | Grubor Nikica M. | Čolović Nataša

Journal: Srpski Arhiv za Celokupno Lekarstvo
ISSN 0370-8179

Volume: 132;
Issue: 9-10;
Start page: 327;
Date: 2004;
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Keywords: floating spleen | torsion of the pedicle | secondary hypersplenism | splenectomy

ABSTRACT
If the spleen is not fixed within the left subphrenic space, it gradually passes into the lower abdomen, where is much more exposed to trauma. Torsion of the splenic pedicle can also occur, causing the infarct necessitating an immediate surgery. Venous stasis causes splenomegaly and sometimes secondary hypersplenism. The authors present 16.5-year old girl with torsion of the splenic pedicle of floating spleen for 720°: in spite of that, the patient had neither splenic infarct nor splenic vein thrombosis, possibly due to thrombocytopenia, but she had splenomegaly and secondary hypersplenism with pancytopenia causing bleeding, sideropenic anemia and mild jaundice. After treatment with iron, the patient underwent splenectomy which resulted in almost immediate rise of the number of all blood cells, and even thrombocytosis. The authors suggest early surgical treatment of the floating spleen, preferably splenopexy, before development of severe complications when splenectomy had to be performed in the majority of patients. Accessory spleens, if present, should be saved.
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