# Ectopic splenic torsion—a challenging diagnosis in a resource-limited setting mimicking a gynecologic emergency: a case report

## TL;DR

A rare case of a twisted wandering spleen was mistaken for a gynecological emergency and required urgent surgery.

## Contribution

Highlights the diagnostic challenge of ectopic splenic torsion in resource-limited settings.

## Key findings

- A 35-year-old woman presented with symptoms mimicking a gynecological emergency but had a torsed wandering spleen.
- Emergency laparotomy revealed a torsed, infarcted wandering spleen, which was surgically removed.
- Imaging and clinical suspicion are crucial for diagnosing rare conditions like ectopic splenic torsion.

## Abstract

A 35-year-old woman presented with severe lower abdominal pain, a history of intermittent abdominal discomfort, increased abdominal girth, and weight loss over the past year. Physical examination revealed a tender abdomen with guarding and a palpable lower abdominal mass. Initial ultrasound suggested a torsed adnexal mass, prompting emergency laparotomy, which revealed a torsed, infarcted wandering spleen. Splenectomy was performed, and the patient recovered well with appropriate post-splenectomy care. Wandering spleen is a rare condition characterized by hypermobility and ectopic positioning of the spleen, often asymptomatic but potentially presenting emergently with torsion and infarction. Diagnosis is challenging, particularly in resource-limited settings, but imaging such as ultrasound or computed tomography (CT) scans can aid in identification. Surgical intervention, including splenopexy or splenectomy, is essential in acute cases.