[Histoire d'une rate errante: un case rare d'abdomen aigu]

ABSTRACT

We present the case of a 17-yearold patient known to have an asymptomatic ectopic spleen, who presented with an acute abdomen. Clinical symptoms and ultrasound led to suspect an acute appendicitis, confirmed later on by pathology. Twenty-four hours after the appendectomy, the patient complained of an abdominal pain of acute onset. Torsion of the pedicle of the ectopic spleen was suspected. Imaging studies supported this diagnosis, and an urgent splenectomy was performed. Did the torsion happen by simple coincidence 24 hours after appendectomy, knowing that the spleen has been asymptomatic for 17 years, or was it precipitated by the surgical intervention ? Should we have removed the ectopic spleen during the appendectomy ? This is the first report of a case of torsion of a wandering spleen after a laparotomy ; a review of the literature is done in order to explain the physiopathology of the disease, and to propose its management