Background: Wandering spleen (WS) is a rare entity which may present as an emergency clinical condition most commonly after torsion of the splenic vessels. Nevertheless even after surgical treatment it has potential for complications which may necessitate emergency treatment. The difficulties in making the diagnosis can delay the appropriate surgical treatment.
Methods: All the patients with WS treated as an emergency between 1996 to 2016 at the Department of Pediatric and Adolescent Surgery of The Schneider Children`s Medical Center of Israel were retrospectively reviewed. Also review of the relevant literature was done.
Results: Among a total of 10 patients treated for wandering spleen, 5 of them underwent 7 emergency surgeries. One of those patients was operated immediately on his first arrival to medical care. Surgical treatment for the other 4 patients was delayed either due to misdiagnosis or for repetitive imaging once the diagnosis was already done. At the time of the emergency surgery the spleen was ischemic in all patients and 3 of them ended up with splenectomy while in 2 patients the spleen was preserved. 4 of the 7 emergency surgeries were done as the first surgery and 3 where done to deal with complications.
Conclusions: WS should ideally be treated as an elective or semi elective procedure in order to reduce the unfavorable results involving emergency surgery. Delays in operating patients with WS could be partially minimized by high index of suspicion for that diagnosis on one hand and by yielding unnecessary and time consuming imaging modalities on the other hand.
