An unusual case of acute abdomen: Torsion of wandering spleen

Abstract

Torsion of wandering spleen is a rare clinical condition in which the spleen is devoid of its normal peritoneal attachment associated with a long vascular pedicle. Women between 20-40 years of age are more likely to be affected. The most common clinical picture is an abdominal mass with pain. For preoperative diagnosis, a high index of suspicion is helpful. Ultrasonography and computerized tomography can also confirm the diagnosis. The treatment is surgical and splenopexy should be the first choice. If ischemia is persistent after detorsion, either laparoscopic or open splenectomy is the choice of procedure. A 26 year old male patient with torsion of an ectopic spleen presenting as a case of acute abdomen is presented in this report. An urgent laparotomy and splenectomy was performed and the patient was discharged at the postoperative third day.

We can say that the torsioned wandering spleen should be kept in mind in every patient who undergoes an urgent operation for acute abdomen, although it is an unusual clinical condition.