日本小児放射線学会雑誌
Online ISSN : 2432-4388
Print ISSN : 0918-8487
ISSN-L : 0918-8487
症例報告
腹部dynamic CTにより遊走脾捻転を診断し自然整復した稀な1例
山﨑 幸太上野 健太郎武田 桃子海野 浩寿伊藤 亮臼井 秀仁伊東 建
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2018 年 34 巻 1 号 p. 31-35

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Wandering spleen is a very rare entity, and a cause of splenic infarction. Splenic infarction presents acute abdomen and requires emergent surgery occasionally. Thus, early diagnosis is very important as soon as possible. A 14-year-old boy presented with fever and abdominal pain for 4 days, and was admitted to our hospital. At first, we detected a loss of splenic artery flow to the spleen and a large spleen by abdominal ultrasonography. Next, we suspected splenic infarction by finding non-enhancing areas in the whole spleen by abdominal enhanced CT. Additionally, we could correctly diagnose torsion of wandering spleen by finding whirl sign of twisting of splenic vessels with abdominal dynamic CT. After a diagnosis, conservative treatment, not but surgical treatment, led to improvement of symptoms and loss of splenic artery flow by torsion of the wandering spleen. Therefore, we considered that his spleen had shown transient ischemic change by torsion of the wandering spleen. We reported that abdominal dynamic CT is clinically useful for identification of torsion of wandering spleen, and the patient was a rare case that improved with conservative treatment.

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