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 is found lower in the abdomen or in the pelvic region. Wandering spleen is usually demonstrated as asymptomatic abdominal mass, intermittent abdominal pain or acute abdomen. Here, we reported one case of acute torsion of wandering spleen. A 20 years old virgin woman with acute hypogastric, right and left 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 it confirmed the presence of a pelvic spleen twisted several rounds on its long vascular pedicle, with congestion, 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 of wandering spleen include infarction, gangrene, splenic abscess, variceal hemorrhage and pancreating necrosis. The usual treatment is fixation of the spleen (spleopexy) except in cases of complications where splenectomy is preferred.