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Case report: splenic torsion

Torsion of spleen is a rare complication, The presence oflong vascular pedicle and absence of natural suspensory ligaments attachements to peritoin and abdominal wall predispose to this complication. Therefore, the spleen may be found anywhere in the abdominal Cavity or in pelvic. The spleen may be twisted around its vascular pedicle and causes strangulation of these vescels and even infarction. Clinical presentations of wandering spleen are variable and are misleading. These presentations may be acute or chronic. Physical examination may show a tender or a non-tender mass with or without acute abodominal pain. Generally, if splenic torsion occurs, the patient presents with fever, vomiting and an acute abdomen. In face of recurrent torsion and detorsion, colicky or vague abdominal pain is presented. Early diagnosis of wandering spleen or torsion before operation without imaging studies is difficult. Treatment commonly entails splenopexy in the left subdiaphragma if the patient is young and if there is no ischemia and is splenectomy if ischemia and gangrene has occured. Our patient refered us with an acute abdominal pain. She was candidate for emergency laparatomy with primary diagnosis of ovarian torsion. Duimg the operation torsion of spleen was found and splenectomy was performed. Preoperative sonography could not help in diagnosis.