title: Ectopic spleen: An easily identifiable but commonly undiagnosed entity until manifestation of complications.
abstract: BACKGROUND
  Ectopic spleen is an uncommon clinical entity as splenectomy for treatment of ectopic spleens accounts for less than 0.25% of splenectomies. The most common age of presentation is childhood especially under 1 year of age followed by the third decade of life.
  
  
  METHODS
  The present report refers to a patient with torsion of a pelvic spleen treated with splenectomy. The patient exhibited a period of vague intermittent lower abdominal pain lasted 65 days followed by a period of constant left lower quadrant pain of increasing severity lasted 6 days. On the first 65 days, vague pain was attributed to progressive torsion of the spleen which resulted in venous congestion. On the last 6 days, exacerbation of pain was attributed to irreducible torsion, infraction of the arterial supply, acute ischemia, strangulation and rupture of the gangrenous spleen. Diagnosis was made by CT which revealed absence of the spleen in its normal position, a homogeneous pelvic mass with no contrast enhancement, free blood in the peritoneal cavity, and confirmed by laparotomy.
  
  
  CONCLUSIONS
  Clinical manifestations of ectopic spleen vary from asymptomatic to abdominal emergency. Symptoms are most commonly attributed to complications related to torsion. Operative management, including splenopexy or splenectomy, is the treatment of choice in uncomplicated and complicated cases because conservative treatment of an asymptomatic ectopic spleen is associated with a complication rate of 65%.
  
  
  CONCLUSIONS
  Although an ectopic spleen can be easily identified on clinical examination, it is commonly misdiagnosed until the manifestation of complications in adulthood.
authors: Department of General Surgery, General Hospital of Drama, Drama, Greece. Electronic address: kostasblu@hotmail.com.
authors: Konstantinos
authors: K
authors: Blouhos
authors: Department of General Surgery, General Hospital of Drama, Drama, Greece. Electronic address: katerinantwna@hotmail.com.
authors: Konstantinos A
authors: KA
authors: Boulas
authors: Department of General Surgery, General Hospital of Drama, Drama, Greece. Electronic address: alkis_salpigktidis@windowslive.com.
authors: Ilias
authors: I
authors: Salpigktidis
authors: Department of General Surgery, General Hospital of Drama, Drama, Greece. Electronic address: nikos_barettas@yahoo.gr.
authors: Nikolaos
authors: N
authors: Barettas
authors: Department of General Surgery, General Hospital of Drama, Drama, Greece. Electronic address: ahatzigeorgiadis@gmail.com.
authors: Anestis
authors: A
authors: Hatzigeorgiadis
keywords: Ectopic spleen; Rupture; Strangulation; Torsion; Wandering spleen