The wandering spleen: CT findings and possible pitfalls in diagnosis.
OBJECTIVE
To report the CT features of wandering spleen, a rare condition which can be incidentally detected as an abdominal or pelvic mass or can present with torsion, causing an acute abdomen.


METHODS
The CT studies of seven patients, two children and five adults, with wandering spleen were reviewed. CT was performed urgently in three patients for acute abdomen, and electively in four.


RESULTS
CT findings of wandering spleen included absence of the spleen in its normal position and a mass located elsewhere in the abdomen or pelvis, i.e. an ectopic spleen, enhancing homogeneously in four cases and failing partially or completely to enhance in the other three, indicating infarction. A "whirl" appearance representing the twisted splenic pedicle was seen in the three cases with torsion. Urgent splenectomy confirmed infarction secondary to torsion.


CONCLUSIONS
The possible diagnosis of wandering spleen should be kept in mind when CT shows the spleen to be absent from its usual position and a mass is found elsewhere in the abdomen or pelvis. When, in addition, a "whirl" or partial or no enhancement of this mass are seen in a case presenting with acute abdomen, torsion of a wandering spleen is a likely diagnosis.
Ben Ely
A
A
Department of Diagnostic Imaging, Assaf Harofeh Medical Center, Zerifin, Israel. liogonky@yahoo.com
Zissin
R
R
Copel
L
L
Vasserman
M
M
Hertz
M
M
Gottlieb
P
P
Gayer
G
G
D000006:Abdomen, Acute / Q000000981:diagnostic imaging; D034841:Abdominal Cavity / Q000000981:diagnostic imaging; D015746:Abdominal Pain / Q000000981:diagnostic imaging; D000328:Adult; D002648:Child; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D013154:Spleen / Q000000981:diagnostic imaging* / Q000601:surgery; D013156:Splenectomy; D013159:Splenic Infarction / Q000000981:diagnostic imaging / Q000601:surgery; D014057:Tomography, X-Ray Computed; D014102:Torsion Abnormality / Q000000981:diagnostic imaging / Q000601:surgery; D050805:Wandering Spleen / Q000000981:diagnostic imaging* / Q000601:surgery