Acute torsion of wandering spleen: report of one case

Wandering spleen is a rare disorder in which the spleen is not located in the left upper quadrant but isfound lower in the abdomen or in the pelvic region. Wandering spleen is usually demonstrated asasymptomatic abdominal mass, intermittent abdominal pain or acute abdomen. Here, we reported onecase of acute torsion of wandering spleen. A 20 years old virgin woman with acute hypogastric, right andleft lower abdominal pain, nausea and vomiting was referred to Amir Al Momenin hospital in Semnan(Iran). Physical examination revealed a generalized tenderness with preference in right lower abdomen,rebound tenderness and guarding. With diagnosis of acute abdomen, laparatomy was performed that itconfirmed the presence of a pelvic spleen twisted several rounds on its long vascular pedicle, withcongestion, partial infarction, and gangrene. Then, splenectomy was carried out for the patient.Clinical presentation of wandering spleen is varied and the diagnosis is often elusive. Complications ofwandering spleen include infarction, gangrene, splenic abscess, variceal hemorrhage and pancreatingnecrosis. The usual treatment is fixation of the spleen (spleopexy) except in cases of complications wheresplenectomy is preferred.