WordNet

travelling about without any clear destination; "she followed him in his wanderings and looked after him" (同)roving, vagabondage
a large dark-red oval organ on the left side of the body between the stomach and the diaphragm; produces cells involved in immune responses (同)lien

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歩き回る,さまよう / 曲がりくねる / 放浪,さすらい / うわごと
脾臓(ひぞう) / 〈U〉不きげん,かんしゃく

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2013/01/22 17:21:56」(JST)

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Wandering spleen (or Pelvic spleen) is a rare medical disease caused by the loss or weakening of the ligaments that help to hold the spleen.

Background

Wandering spleen is most commonly diagnosed in young children^[1] as well as women between the ages of 20 and 40.^[2] Even so, the disease is very rare and fewer than 500 occurrences of the disease have been reported as of 2005,^[1] of which around 148 (including both children and adult cases) were documented to have been from between 1960 and 1992.^[3] Less than 0.5% of all splenectomies, surgical removal of the spleen, are performed due to having this disorder.

Characteristics of the disorder include the loss, weakening, or malformation of the ligaments^[4] that help to keep the spleen located in the upper left part of the abdomen. Though not a genetic disease, wandering spleen is often found at birth. It can occur in adults as the result of injuries and other similar conditions that cause the ligaments to weaken, such as connective tissue disease or pregnancy.^[4]

In 1992, the youngest case of the literature of torsion of wandering spleen at two days of birth was reported in Lebanon, by Dr Edouard Sayad.^[5]

Symptoms

Symptoms include an enlargement in the size of the spleen,^[4] or a change from the spleen's original position to another location, usually in either other parts of the abdomen or into the pelvis. This ability to move to other locations is commonly attributed to the spleen's pedicle being abnormally long.^[1]

Physical factors may cause ischuria, constipation, as well as numerous spleen-related diseases such as hypersplenism, thrombocytopenia, and lymphoma.^[3] Blocking of the arteries and torsion in the spleen can also result in abdominal pain or swelling.^[6] However, lack of visible symptoms — except in incidents of abdominal pain — makes the disease difficult for doctors to diagnose,^[2] though medical imaging techniques such as medical ultrasonography, magnetic resonance imaging, or computed tomography can be used to confirm its occurrence.

Treatment

The usual treatment is splenopexy, fixation of the spleen, but if there is no blood flow after unwinding the spleen through detorsion then splenectomy must be performed.^[2] Although there have been few reported cases of treatment through laparoscopic surgery due to the rarity of the disease, it has been proven to be an effective surgical technique.^[7]

In popular culture

Susan Mayer on the TV show Desperate Housewives had an operation to fix her wandering spleen in Season 2 of the show.

References

^ ^a ^b ^c Hasan Alawi, Malak; Ahmad Khalifa, Sami Hassan Bana (October-December 2005). "Wandering Spleen: A Challenging Diagnosis" (PDF). Pakistan Journal of Medical Sciences. Open Publishing. http://www.pjms.com.pk/issues/octdec05/pdf/wandering_spleen.pdf. Retrieved 2007-02-25.
^ ^a ^b ^c Safioleas MC, Stamatakos MC, Diab AI, Safioleas PM (January 2007). "Wandering spleen with torsion of the pedicle". Saudi Med J 28 (1): 135–6. PMID 17206307.
^ ^a ^b Satyadas T, Nasir N, Bradpiece HA (April 27, 2002). "Wandering spleen: case report and literature review". J. R. Coll. Edinb. 47: 512–4. http://www.rcsed.ac.uk/journal/vol47_2/4720012.html.
^ ^a ^b ^c "Wandering Spleen". NORD. http://www.rarediseases.org/search/rdbdetail_abstract.html?disname=Wandering%20Spleen. Retrieved 2007-02-25.
^ "Error: no |title= specified when using {{Cite web}}". http://www.ncbi.nlm.nih.gov/pubmed/1339897.
^ "Wandering spleen". http://www.medcyclopaedia.com/library/topics/volume_vii/w/wandering_spleen.aspx. Retrieved 2007-02-26.
^ Castellón-Pavón CJ, Valderrábano-González S, Anchústegui-Melgarejo P, et al. (December 2006). "[Laparoscopic splenectomy due to torsion of a wandering spleen"] (in Spanish; Castilian). Cir Esp 80 (6): 406–8. PMID 17192227. http://www.elsevier.es/revistas/0009-739X/80/406.

UpToDate Contents

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1. 成人における腹痛の鑑別診断 differential diagnosis of abdominal pain in adults
2. 小児および思春期における急性腹症の原因 causes of acute abdominal pain in children and adolescents
3. 脾腫およびその他の脾疾患を有する成人患者に対するアプローチ approach to the adult patient with splenomegaly and other splenic disorders
4. 脾腫を有する小児に対するアプローチ approach to the child with an enlarged spleen
5. プルーンベリー症候群 prune belly syndrome

English Journal

Wandering spleen with gastric volvulus and intestinal non-rotation in an adult male patient.

Ooka M1, Kohda E1, Iizuka Y1, Nagamoto M1, Ishii T2, Saida Y2, Shimizu N3, Gomi T1.Author information 1Department of Radiology, Toho University Ohashi Medical Center, Tokyo, Japan.2Department of Surgery, Toho University Ohashi Medical Center, Tokyo, Japan.3Department of Pediatrics, Toho University Ohashi Medical Center, Tokyo, Japan.AbstractWe report an extremely rare case of wandering spleen (WS) complicated with gastric volvulus and intestinal non-rotation in a male adult. A 22-year-old man who had been previously treated for Wilson disease was admitted with severe abdominal pain. Radiological findings showed WS in the midline of the pelvic area. The stomach was mesenteroaxially twisted and intestinal non-rotation was observed. Radiology results did not show any evidence of splenic or gastrointestinal (GI) infarction. Elective emergency laparoscopy confirmed WS and intestinal non-rotation; however, gastric volvulus was not observed. It was suspected that the stomach had untwisted when gastric and laparoscopic tubes were inserted. Surgery is strongly recommended for WS because of the high risk of serious complications; however, some asymptomatic adult patients are still treated conservatively, such as the patient in this study. The present case is reported with reference to the literature.
Acta radiologica short reports.Acta Radiol Short Rep.2013 Nov 18;2(7):2047981613499755. doi: 10.1177/2047981613499755.
We report an extremely rare case of wandering spleen (WS) complicated with gastric volvulus and intestinal non-rotation in a male adult. A 22-year-old man who had been previously treated for Wilson disease was admitted with severe abdominal pain. Radiological findings showed WS in the midline of the
PMID 24349711

[Infarction of a wandering spleen - A case report.]

Bouzaidi K, Daghfous A, Ben Ali M, Karma S, Rezgui Marhoul L.
Presse medicale (Paris, France : 1983).Presse Med.2013 Oct 31. pii: S0755-4982(13)00768-9. doi: 10.1016/j.lpm.2013.04.022. [Epub ahead of print]
PMID 24184280

Japanese Journal

症例腹腔鏡下脾臓摘出術を行った骨盤内遊走脾の1例

高久秀哉,春日信弘,鈴木俊繁 [他]
外科 75(1), 107-109, 2013-01
NAID 40019542416

腹腔鏡下脾固定術を施行した遊走脾の1例

安田裕美,大井正貴,北嶋貴仁,沖上正人,岩田崇,井上幹大,毛利靖彦,楠正人
日本外科系連合学会誌 37(6), 1170-1175, 2012-12-30
NAID 10031152873

術前診断した遊走脾茎捻転の1例

大塚新平,磯谷正敏,原田徹,金岡祐次,前田敦行,高山祐一
日本臨床外科学会雑誌 = The journal of the Japan Surgical Association 73(10), 2669-2673, 2012-10-25
NAID 10031147739

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関連記事	「wandering」

「wandering」

Wandering spleen
	Classification and external resources
	; A picture of an enlarged spleen taken using medical ultrasonography.
ICD-9	289.59
DiseasesDB	33272
MeSH	D050805

　　[★]

放浪、遊走

関: migrate、migration、wander

[PJMS-1] Hasan Alawi, Malak; Ahmad Khalifa, Sami Hassan Bana (October-December 2005). "Wandering Spleen: A Challenging Diagnosis" (PDF). Pakistan Journal of Medical Sciences. Open Publishing. http://www.pjms.com.pk/issues/octdec05/pdf/wandering_spleen.pdf. Retrieved 2007-02-25.

[S-2] Safioleas MC, Stamatakos MC, Diab AI, Safioleas PM (January 2007). "Wandering spleen with torsion of the pedicle". Saudi Med J 28 (1): 135–6. PMID 17206307.

[UK-3] Satyadas T, Nasir N, Bradpiece HA (April 27, 2002). "Wandering spleen: case report and literature review". J. R. Coll. Edinb. 47: 512–4. http://www.rcsed.ac.uk/journal/vol47_2/4720012.html.

[NORD-4] "Wandering Spleen". NORD. http://www.rarediseases.org/search/rdbdetail_abstract.html?disname=Wandering%20Spleen. Retrieved 2007-02-25.

[5] "Error: no |title= specified when using {{Cite web}}". http://www.ncbi.nlm.nih.gov/pubmed/1339897.

[Med-6] "Wandering spleen". http://www.medcyclopaedia.com/library/topics/volume_vii/w/wandering_spleen.aspx. Retrieved 2007-02-26.

[C-7] Castellón-Pavón CJ, Valderrábano-González S, Anchústegui-Melgarejo P, et al. (December 2006). "[Laparoscopic splenectomy due to torsion of a wandering spleen"] (in Spanish; Castilian). Cir Esp 80 (6): 406–8. PMID 17192227. http://www.elsevier.es/revistas/0009-739X/80/406.

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wandering spleen