2018 Volume 34 Issue 1 Pages 31-35
Wandering spleen is a very rare entity, and a cause of splenic infarction. Splenic infarction presents acute abdomen and requires emergent surgery occasionally. Thus, early diagnosis is very important as soon as possible. A 14-year-old boy presented with fever and abdominal pain for 4 days, and was admitted to our hospital. At first, we detected a loss of splenic artery flow to the spleen and a large spleen by abdominal ultrasonography. Next, we suspected splenic infarction by finding non-enhancing areas in the whole spleen by abdominal enhanced CT. Additionally, we could correctly diagnose torsion of wandering spleen by finding whirl sign of twisting of splenic vessels with abdominal dynamic CT. After a diagnosis, conservative treatment, not but surgical treatment, led to improvement of symptoms and loss of splenic artery flow by torsion of the wandering spleen. Therefore, we considered that his spleen had shown transient ischemic change by torsion of the wandering spleen. We reported that abdominal dynamic CT is clinically useful for identification of torsion of wandering spleen, and the patient was a rare case that improved with conservative treatment.
