Diagnostic clue to acute splenic torsion in the tropics

In three patients with acute torsion of the spleen in the tropics the presenting symptoms included an abdominal mass, pain, and vomiting. In malarious areas adults usually know that they have splenomegaly and hence this fact should be ascertained in the clinical history. In an acute abdominal catastrophe, with a palpable tumour and a history of known splenomegaly, the absence of the spleen in the normal position suggests acute splenic torsion.