Intermittent Torsion of a Wandering Spleen: A Case of Recurrent Acute Abdominal Pain

Wandering spleen is a rare condition resulting from congenital or acquired laxity of the splenic ligaments, predisposing the organ to abnormal mobility and torsion of its vascular pedicle. We report a case of a patient presenting with recurrent episodes of acute abdominal pain due to intermittent torsion of a wandering spleen, characterized by spontaneous resolution between attacks and diagnostic uncertainty on initial evaluation. Clinical presentation was nonspecific, with episodic left-sided abdominal pain and variable examination findings, while routine laboratory investigations were largely unremarkable. Cross-sectional imaging played a decisive role in diagnosis, demonstrating ectopic splenic location in the lower abdomen with an elongated vascular pedicle and features consistent with intermittent torsion. The patient underwent surgical management with intraoperative confirmation of splenic mobility and vascular compromise without established infarction. Definitive treatment resulted in the resolution of symptoms and no recurrence on follow-up. This case highlights the importance of considering wandering spleen in the differential diagnosis of recurrent acute abdomen, particularly when imaging reveals a mobile or ectopic spleen. Early recognition through appropriate imaging is essential to prevent complications such as splenic infarction and to allow timely surgical intervention.