Presentation
Lower abdominal pain, and weakness for about 6 months. During last 3 weeks these episodes were of a higher intensity, and every time these symptoms were present she get the spasmolytics and obtained relief, but it is not during last 5 days. There was no past history of any surgery.
Patient Data
The liver is located on the left hypochondrium. Spleen is located on the right (situs ambiguus), has a multilobular structure, and the maternal lobe is not enlarged. There are many small additional lobes around it (polysplenia syndrome).
In the abdominal cavity (hypo- and mesogastrium) an additional spleen situated with totally absent perfusion (infarcted splenunculus). There is a torsion of its vascular pedicle (whirlpool sign) - the draining vein is spirally coiled, thrombosed; the main splenic vein is contrasted. Adipose tissue (omentum majus) is wrapped around the pedicle.
Case Discussion
After CT patient was examed by surgeon and prepared to surgery (intraoperative video or images are not avaliable).