Splenic torsion

A young male presented with acute abdominal pain of 4 days. Treated as appendicular mass, which did not responds to conservative management. Ultra Sound scan and CT abdomen failed to give a definite diagnosis of the tender fixed mass in lower abdomen. Laparotomy proved the mass to be an engorged large spleen twisted on its long vascular pedicle, the ischemic spleen adherent to bowel loops and posterior peritoneum. Splenectomy performed. Postoperative reactionary hemorrhage required re-exploration and clearance of clots. Patient had uneventful recovery.