Wandering spleen with torsion of the pedicle. A case report and review of the literature

: Congenital deficiency or acquired laxity of the suspensory ligaments, that usually hold the spleen in place in its compartment, may result in extreme splenic mobility. Consequently, this mobility predisposes to torsion of the elongated splenic vascular pedicle creating a situation of acute abdomen due to haemorrhagic infarction. Various imaging modalities for diagnosing the wandering spleen such as ultrasonography, CT scan, MR-angiography, nuclear scan and arteriography are of great value both in the asymptomatic condition and in acute abdomen. We report on an unusual case of wandering spleen with torsion of the pedicle in a middle-aged woman which we casually diagnosed intraoperatively. It was not possible to preserve the wandering spleen by means of splenopexy because the splenic infarction required a splenectomy. Though the condition was not diagnosed prior to surgery, prompt intervention enabled the prognosis to remain unvaried. We review the cases reported in the literature and discuss the diagnostic and therapeutic problems raised by this rare condition.