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Left upper quadrant pain: upside down spleen
Claudia Cotes1, Leonard E Swischuk
1From the *Department of Radiology, and †Pediatric Radiology, The University of Texas Medical Branch, Galveston, TX.
Abstract:
We present the clinical and imaging findings in a patient presenting with left upper quadrant pain. On plain films, a mass was seen in the left upper quadrant, and on computed tomography (CT), a spleen with a whorled pedicle suggesting torsion was identified. However, it was the coronal reconstruction CT study that definitely showed that the spleen had undergone a 180-degree torsion. We refer to the findings on the coronal CT reconstruction as the "upside down" spleen sign, and it was very helpful in clinching the diagnosis.
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