Torsion of a wandering spleen
The patient is a 4 year old girl who brought to ED with acute abdominal pain.
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- absence of the spleen in the left upper quadrant
- whirl sign: whirled appearance of hyperdense, nonenhancing splenic vessels
- enlarged spleen, without enhancement
Wandering spleen is a rare condition in which the spleen migrates from its usual anatomical position, commonly to the lower abdomen or pelvis. Wandering spleen is rare, with a reported incidence of <0.5%.
It can present as an asymptomatic or painful abdominal mass, intermittent abdominal pain, or as an acute abdomen due to torsion 1,2.