Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Oct 6, 2023; 11(28): 6955-6960
Published online Oct 6, 2023. doi: 10.12998/wjcc.v11.i28.6955
Wandering spleen torsion with portal vein thrombosis: A case report
Xin-Yan Zhu, Dong-Xu Ji, Wen-Zai Shi, Yu-Wei Fu, Da-Kun Zhang
Xin-Yan Zhu, Da-Kun Zhang, Department of Ultrasound, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing 100091, China
Xin-Yan Zhu, Yu-Wei Fu, Department of Ultrasound, Peking University International Hospital, Beijing 102206, China
Dong-Xu Ji, Department of Radiology, Peking University International Hospital, Beijing 102206, China
Wen-Zai Shi, Department of Hepatobiliary Surgery, Peking University International Hospital, Beijing 102206, China
Author contributions: Zhu XY performed the data analysis and wrote the manuscript; Ji DX, Shi WZ, Fu YW contributed significantly to the analysis and manuscript preparation; Zhang DK helped perform the analysis with discussions and contributed to the study conception; All authors have read and approved the final version to be published.
Supported by CACMS Innovation Fund, No. CI2021A03317.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Da-Kun Zhang, PhD, Professor, Department of Ultrasound, Xiyuan Hospital, China Academy of Chinese Medical Sciences, No. 1 Xiyuan Playground, Haidian District, Beijing 100091, China. zdk002@163.com
Received: July 28, 2023
Peer-review started: July 28, 2023
First decision: August 17, 2023
Revised: August 29, 2023
Accepted: September 4, 2023
Article in press: September 4, 2023
Published online: October 6, 2023
Abstract
BACKGROUND

Wandering spleen is rare clinically. It is characterized by displacement of the spleen in the abdominal and pelvic cavities and can have congenital or acquired causes. Wandering spleen involves serious complications, such as spleen torsion. The clinical symptoms range from asymptomatic abdominal mass to acute abdominal pain. Surgery is required after diagnosis. Cases of wandering spleen torsion with portal vein thrombosis (PVT) are rare. There is no report on how to eliminate PVT in such cases.

CASE SUMMARY

Ultrasound and computed tomography revealed a diagnosis of wandering spleen torsion with PVT in a 31-year-old woman with a history of childbirth 16 mo previously who received emergency treatment for upper abdominal pain. She recovered well after splenectomy and portal vein thrombectomy combined with continuous anticoagulation, and the PVT disappeared.

CONCLUSION

Rare and nonspecific conditions, such as wandering splenic torsion with PVT, must be diagnosed and treated early. Patients with complete splenic infarction require splenectomy. Anticoagulation therapy and individualized management for PVT is feasible.

Keywords: Portal vein thrombosis, Splenic torsion, Wandering spleen, Case report

Core Tip: Cases of wandering spleen torsion with portal vein thrombosis (PVT) are rare. There is no report on how to eliminate PVT in such cases. Here, we report wandering spleen torsion with PVT in a 31-year-old woman with a history of childbirth 16 mo previously who recovered well after splenectomy and portal vein thrombectomy combined with continuous anticoagulation. The PVT disappeared. Wandering splenic torsion with PVT must be diagnosed and treated early. Patients with complete splenic infarction require splenectomy. Anticoagulation therapy and individualized management for PVT is feasible.