Presentation
Abdominal mass progressive in size with severe pain of acute onset.
Patient Data
The spleen is seen in abnormal mid abdomen position. It is enlarged and of diffuse hypo echoic texture.
A large completely non-enhancing spleen in the lower abdomen and pelvis with twisting of the splenic artery and vein within the mid abdomen consistent with an enlarged, ectopic and completely infarcted spleen.
Case Discussion
The spleen can ‘wander’ due to excessive mobility associated with ligamentous laxity of its peritoneal attachments. There are multiple causes of this ligamentous laxity including congenital and acquired etiologies. In the congenital form, there is failure of development of the normal splenic suspensory ligaments including the lienorenal and gastrosplenic ligaments. The acquired form can occur in conditions that weaken the ligaments including pregnancy with elevated estrogen levels and after trauma.
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