A case of torsed wandering spleen presenting as perforated acute appendicitis: A case report and literature review
Year: 2025
Type: article
Study design: Case Report
Abstract: INTRODUCTION: Wandering spleen (WS) is a rare circumstance characterized via exaggerated splenic mobility because of absent or lax suspensory ligaments. It predisposes the spleen to torsion, that could purpose infarction, rupture, or gangrene, requiring urgent intervention. PRESENTATION OF CASE: We report a 10-year-old girl with a three-day history of acute abdominal pain, vomiting, and fever. Physical examination revealed diffuse tenderness, predominantly in the right lower quadrant (RLQ), mimicking appendicitis. Ultrasound and CT showed WS with torsion, showing the characteristic whirl sign. Emergency laparotomy revealed a 720-diploma splenic torsion with necrosis, necessitating splenectomy. The patient had an uneventful recovery and was discharged on postoperative day five. DISCUSSION: WS is an extraordinary entity (<0.2 % occurrence) with a bimodal age distribution, often affecting adolescents and girls. It can be congenital or acquired and presents variably, from asymptomatic cases to acute abdomen. Torsion leads to vascular compromise, requiring prompt surgical intervention. This case was very interesting to the surgical team for its atypical presentation and its resemblance to perforated appendicitis. CONCLUSION: WS must be considered in cases of acute abdomen with an absent spleen on imaging. Early recognition and surgical intervention are essential to prevent complications in patients with acute abdomen. Ultrasound and CT are critical for early detection and differentiation from different abdomen emergencies.
Authors: Ayat Aljuba, Alaa R. AL-Ihribat, Bahaa AbuRahmeh, Noor Khashan, Kareem lbraheem, Yara al Najajreh
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,090
OpenAlex ID: W4410218035