Wandering spleen is rare, particularly in children, and diagnosis is difficult. It usually occurs at 20 to 40 years of age, and most cases are seen in women. Diagnosis is difficult because of lack of symptoms, unless splenic torsion has occurred. Patients usually have an asymptomatic abdominal mass, an acute abdomen, or, most commonly, a mass associated with pain.
Treatment is operative because of complications of splenic infarction and possible splenectomy.
Splenopexy is the treatment of choice for a noninfarcted wandering spleen. Splenectomy should be done only when there is no evidence of splenic blood flow after detorsion of the spleen. We review our experience with wandering spleen in two pediatric patients, one treated with splenopexy and the other with splenectomy. The spleen can be found in any part of the abdomen or pelvis because of the length of its pedicle.2 Because of this abnormal fixation, the spleen can twist on its vascular pedicle, creating ischemia that may progress to infarction if not promptly treated. We report two cases of wandering spleen in pediatric patients and discuss diagnosis, use of imaging studies, and optimal treatment.