[Acute abdomen in hemorrhage into a twisted pedicled ectopic second spleen in the right mesogastrum]

A woman patient of 25 years of age was admitted with a tumour in the right meogastrium that was painful on pressure, the clinical pattern being that of an acute abdomen. At exploratory laparotomy we were surprised to find haemorrhagic infarction of a second spleen by volvulus of the vascular peduncle. Preoperative imaging had not yielded any pointer despite documentation of multiple positional anomalies of visceral organs, since the polysplenic status was exceptionally located at the right side. If abdominal findings on the right side cannot be interpreted quite clearly, differential diagnosis should always consider the possibility of unusual embryonal lateral positioning of organs.