Wandering spleen with tortion leading to infarction

Abstract

Wandering spleen is a rare condition occurs from a failure of fusion of the mesogastrium and the lining body wall epithelium. Acute tortion of wandering spleen is a potentially fatal and difficult to diagnose surgical emergency. So, diagnosis may still be missed despite diverse diagnostic modalities. We present a case of 24-year-old female, who had severe abdominal pain in left upper abdomen and a palpable mass in left iliac with Leukocytosis. Initial CT scan revealed a hypodense area in left iliac fossa, which was labelled and treated as intraabdominal abscess. Following her miscarriage, she was referred to us due to persistent pain and fever. A diagnosis of wandering spleen was made on ultrasound and confirmed on CT scan with typical signs of tortion. Splenectomy was done with uneventful recovery.

WS ranges from asymptomatic to a life threatening abdominal emergency and diagnosis may be challenging due to vague and nonspecific features. Early diagnosis of tortion is crucial in the management and contrast enhanced CT is the best modality to diagnose WS.