LAPAROSCOPIC PREPERITONEAL SPLENOPEXY FOR A PEDIATRIC WANDERING SPLEEN rjastrolabio55555@gmail.com

 

LAPAROSCOPIC PREPERITONEAL SPLENOPEXY FOR A PEDIATRIC WANDERING SPLEEN

2

Philippines

Oral or Poster

Wandering spleen is a rare congenital condition caused by the absence or laxity of splenic ligaments, leading to increased mobility within the abdomen. It is a critical differential diagnosis in patients presenting with acute or chronic abdominal pain, as complications such as torsion, infarction, and rupture can occur. Due to its variable presentation, early recognition is essential to prevent life-threatening outcomes.

We report the case of an 11-year-old male with a four-month history of intermittent crampy pain in the hypogastric and left lower quadrant regions, occasionally associated with nausea and vomiting. Physical examination revealed mild abdominal tenderness with a palpable mass. A contrast-enhanced CT scan confirmed a wandering spleen, showing displacement with vascular congestion but no infarction.

Given the risk of torsion, the patient underwent laparoscopic preperitoneal splenopexy using a novel technique. A preperitoneal pocket was created without mesh to secure the spleen, reinforced with tackers and sutures. The postoperative course was uneventful, with complete symptom resolution and no recurrence at follow-up.

Wandering spleen should be considered in pediatric patients with abdominal pain. Early imaging-based diagnosis is crucial to prevent complications. Laparoscopic splenopexy is a safe, minimally invasive approach that preserves splenic function and prevents recurrence. Our preperitoneal fixation technique without the use of mesh offers a promising alternative for spleen stabilization in pediatric patients.