title: Left upper quadrant pain: upside down spleen.
abstract: We present the clinical and imaging findings in a patient presenting with left upper quadrant pain. On plain films, a mass was seen in the left upper quadrant, and on computed tomography (CT), a spleen with a whorled pedicle suggesting torsion was identified. However, it was the coronal reconstruction CT study that definitely showed that the spleen had undergone a 180-degree torsion. We refer to the findings on the coronal CT reconstruction as the "upside down" spleen sign, and it was very helpful in clinching the diagnosis.
authors.affiliation: From the *Department of Radiology, and †Pediatric Radiology, The University of Texas Medical Branch, Galveston, TX.
authors.forename: Claudia
authors.initials: C
authors.lastname: Cotes
authors.forename: Leonard E
authors.initials: LE
authors.lastname: Swischuk
mesh_terms: D015746:Abdominal Pain / Q000209:etiology*; D002675:Child, Preschool; D004630:Emergencies; D006801:Humans; D007091:Image Processing, Computer-Assisted; D013154:Spleen / Q000000981:diagnostic imaging; D013158:Splenic Diseases / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D013163:Splenomegaly / Q000000981:diagnostic imaging / Q000209:etiology; D014057:Tomography, X-Ray Computed; D014102:Torsion Abnormality / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery