Splenic hypoperfusion due to torsion

Case contributed by Dr Mert Bayramoglu

Presentation

Severe left upper and lower quadrant pain for several days. Attended 3 emergency departments with no diagnosis made.

Patient Data

Age: 20 years
Gender: Female

Portal phase CT images show a hypoperfused spleen, patent splenic artery and contrast in the splenic vein near its confluence with the portal vein but not in the part near the spleen. Delayed phase CT images reveal a patent splenic vein. Perisplenic minimal fluid is also noted.

Case Discussion

Partial torsion of the spleen causes obstruction of the splenic vein and consequently hypoperfused spleen. The cause of splenic torsion appears to be related to issues with the attaching ligaments such as weakening or malformation. Usually, splenic torsion is seen in association with a wandering spleen (splenoptosis), however, in this case the spleen seems is in a normal location.

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Case information

rID: 42338
Published: 17th Jan 2017
Last edited: 16th Feb 2019
Inclusion in quiz mode: Included

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