Ectopic splenic volvulus and infarction: a case report

A wandering (ectopic) spleen is a rare clinical condition caused by laxity or absence of the splenic ligaments, predisposing it to torsion and subsequent infarction. A computed tomography (CT) scan remains one of the most valuable diagnostic modalities for identifying this condition and its complications.

We report the case of a 53-year-old woman who presented with non-specific lower abdominal pain. CT of the abdomen revealed an ectopic spleen complicated by torsion and infarction. Emergency laparotomy showed a twisted vascular pedicle and hemoperitoneum with splenic lacerations. Splenectomy was performed, and histology confirmed infarction.

Volvulus with infarction of an ectopic spleen is a rare cause of an acute abdomen that mimics other, more common causes, making CT imaging essential for diagnosis, with features such as the whirl sign and an absent splenic position. Management depends on the viability of the spleen. Splenopexy is considered when the spleen is viable, whereas splenectomy is performed in cases of infarction.

Torsion of a wandering spleen is a surgical emergency. Early diagnosis and prompt surgical intervention will reduce the likelihood of splenectomy and thereby the risk of related complications.