Presentation
Abdominal pain and fever.
Patient Data
Wandering spleen noted. This lies centrally near the pelvic inlet and displaces the bladder to the right. There is normal enhancement, with no evidence of acute splenic infarction although peripheral coarse calcifications may reflect previous events.
Multiple gall stones. Sigmoid and descending colonic diverticula.
Bilateral inguinal hernias, that on the right containing a small portion of the bladder.
Case Discussion
Wandering spleen results from abnormality of the suspensory ligaments of the spleen, namely the gastrosplenic and lienorenal ligaments. There may either be a congenital absence or underdevelopment of these ligaments, or an acquired laxity. The resultant elongated splenic pedicle predisposes to splenic torsion and infarct.
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