Massive splenic infarction in a wandering spleen: A rare indication for emergency splenectomy

An 18-year-old woman with a history of delayed maturation came to the emergency department for pain in the left hypochondrium over the previous 4 days and fever. On examination, she presented pain in the left iliac fossa, where a well-defined rounded mass was palpable. Lab work showed 15 000 leukocytes/μL and CRP 154 mg/L.

CT scan revealed a wandering spleen with torsion of the vascular pedicle and massive secondary infarction (Fig. 1). During urgent surgery, an ischemic wandering spleen was observed at the level of the pelvis, with complete hilar torsion (Fig. 2). Detorsion and splenectomy were performed, and the patient’s condition progressed favorably.

Figure 1

Figure 2

The etiology of wandering spleen is the absence or abnormal development of the suspensory ligaments of the spleen.