Torsion of the spleen can occur if the spleen is sufficiently mobile.
Risk factors for splenic torsion:
(1) accessory spleen or polysplenia
(2) congenital absence of the normal peritoneal suspensory ligaments ("wandering" spleen)
(3) traumatic or iatrogenic lysis of the suspensory ligaments
(4) congenital anomalies of the abdomen
(5) moderate to marked splenomegaly
Presentation: acute abdominal pain with or without a palpable mass
The diagnosis of torsion can be made by contrast-enhanced CT.
The presence of thrombocytosis may be predictive for splenic infarction (Wang et al).
Complications:
(1) splenic infarction
(2) postoperative portal vein thrombosis
Splenectomy may be performed:
(1) if there is no evidence of splenic blood flow after detorsion
(2) if there is massive infarction of the spleen
