Splenic Torsion From a Wandering Spleen

Wandering spleen is a unique condition defined as a hypermobile spleen with a sole attachment to its vascular pedicle. The most common complication is torsion of the spleen, resulting in a surgical emergency. Early diagnosis and prevention of splenic infarction are the mainstays of treatment to help preserve immunologic function. We report a case of torsion of the wandering spleen in a 23-year-old active-duty male with a prior childhood history of duodenal atresia. His abdominal examination demonstrated a palpable midline mass, which was confirmed by CT abdomen and pelvis to be a wandering spleen with twisting of the vascular pedicle. The patient was taken for an exploratory laparotomy, where an infarcted spleen was identified with associated twisting of the splenic hilum, and a splenectomy was performed. Post-operatively, the patient is healthy and symptom-free at the three-month follow-up and has returned to active duty.