Purpose:
To summarize our experience with sonographic diagnosis of wandering spleen in children and assess for the typical sonographic findings of wandering spleen, complications, and possible diagnostic pitfalls.
Methods:
We identified all pediatric patients from 1998-2003 with a surgically confirmed diagnosis of wandering spleen. all sonographic examinations were reviewed for splenic position, size, echotexture, and parenchymal blood flow.
Results:
Seven children were identified with a mean age of 9.7 years (range 4.2-15.3 years). all presented with abdominal pain. abdominal sonography, performed in all children demonstrated a low position of the spleen (n = 6), splenomegaly (n = 4), and absence of parenchymal flow in the three patients with splenic torsion and infarction. the diagnosis was made preoperatively via sonography in five children; three required repeated hospital admissions before the correct diagnosis was established. complications occurred in five patients (gastric obstruction [n = 1], splenic infarction [n = 3], and recurrent pancreatitis [n = 1]).
Conclusion:
The most specific sonographic finding for wandering spleen is low position of the spleen. however, if the spleen regains its normal or near-normal position, the diagnosis may be missed and the condition may recur, and result in complications.