Wandering spleen is a rare condition caused by lax or absent splenic ligaments, which allows abnormal splenic mobility and predisposes the organ to torsion and infarction. Clinical presentation is often nonspecific, making imaging crucial for diagnosis. We report a 27-year-old woman who presented with a 5-day history of acute left upper quadrant abdominal pain radiating to the left shoulder, accompanied by nausea and constipation. Laboratory investigations revealed leukocytosis with neutrophil predominance, lymphopenia, and markedly elevated C-reactive protein and lactate dehydrogenase. Contrast-enhanced CT revealed an ectopic spleen with minimal enhancement and a whirl-sign of the twisted vascular pedicle. Laparotomy confirmed torsion with infarction, and splenectomy was performed. This case highlights the diagnostic challenge of wandering spleen and the critical role of contrast-enhanced CT in identifying torsion. Prompt recognition and surgical intervention are essential to prevent infarction and life-threatening complications.
Alfakhry et al. (Thu,) studied this question.