Question:

Ectopic spleen is caused by all the following except:
1. Congenital absence of peritoneal ligaments of the spleen.
2. The peritoneum overlying the left kidney does not fuse completely with the dorsal mesogastrium.
3. Multiple pregnancies.
4. Trauma.
5. Splenomegaly.





Answer:

The correct answer for the question "Ectopic spleen is caused by all the following except:" is:

1. Congenital absence of peritoneal ligaments of the spleen.



Explanation
1.    [The spleen is held in its normal position by the gastrosplenic, splenorenal, splenocolic and phrenocolic ligaments. The congenital or acquired laxity of these peritoneal attachments of the spleen results in splenic hypermobility, leading to a wandering or ectopic spleen.]

2.    [Embryologic basis of congenital laxity is incomplete fusion of dorsal mesogastrium with the peritoneum overlying the left kidney.]

3.    [Multiparity, hormonal effects of pregnancy leading to laxity of ligaments & abdominal wall, trauma and splenomegaly are some of the proposed causes of acquired increase in splenic mobility.]

4.    [Multiparity, hormonal effects of pregnancy leading to laxity of ligaments & abdominal wall, trauma and splenomegaly are some of the proposed causes of acquired increase in splenic mobility.]

5.    [Multiparity, hormonal effects of pregnancy leading to laxity of ligaments & abdominal wall, trauma and splenomegaly are some of the proposed causes of acquired increase in splenic mobility.]



From the manuscript:
Tale of a wandering spleen: 1800 degree torsion with infarcted spleen and secondary involvement of liver
Radiology Case. 2014 Jun; 8(6):18-26


This article belongs to the GI section.




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From the manuscript

Tale of a wandering spleen: 1800 degree torsion with infarcted spleen and secondary involvement of liver

Free full text article: Tale of a wandering spleen: 1800 degree torsion with infarcted spleen and secondary involvement of liver

Abstract
Wandering spleen is a rare clinical entity characterized by splenic hypermobility resulting from laxity or maldevelopment of the suspensory splenic ligaments. The spleen can "wander" or migrate into various positions within the abdomen or pelvis due to this ligamentous laxity. It is usually detected between 20 and 40 years of age, and is more common in women. The clinical presentation of a wandering spleen is variable, it could present as an asymptomatic, incidentally detected, abdominal or pelvic mass, or as an acute abdomen secondary to splenic torsion. Diagnosis in an emergent setting can be challenging as it is a rare cause of acute abdomen and does not produce any symptoms until splenic torsion has occurred. We present and discuss a case of ectopic, torsed spleen resulting in complete infarction of the spleen and severe hepatic vascular compromise, diagnosed by ultrasound, confirmed by computed tomography and effectively managed by splenectomy.






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