Wandering spleen is very rare condition in children characterized by migration of the spleen from its normal position due to laxity or absence of the supporting splenic ligaments. We experienced a case of splenic infarction due to torsion of a wandering spleen in a 6-year-old boy who presented with fever, vomiting, and abdominal pain of 2 day's duration. On physical examination, there was severe tenderness in the left upper quadrant of the abdomen. The plain abdominal radiograph showed marked colonic gaseous distension. Contrast-enhanced abdominal computed tomography scan showed decreased density of spleen in the normal position, consistent with infarction. At emergency laparotomy, a wandering spleen twisted 360° on its pedicle was found. Despite splenic detorsion, blood flow could not be restored. Splenectomy was therefore performed. The child was discharged 7 days after surgery without any complications.

Torsion of the wandering spleen is a rare condition especially in children. Unfortunatly, splenectomy was the advocated treatment of choice for wandering spleen in many children up to 1985 in spite of the well-known possibility of overwhelming postsplenectomy sepsis. Because of the conclusive evidence of the vital function of the spleen in infection, indication of splenectomy have been revised and more attention has been paid to preserving the spleen where possible. We are presented a girl with splenic torsion, seen as a migratory abdominal mass and intermittent vague abdominal pain. Splenopexy by fixation of the spleen to the diaphragm and posterolateral peritoneum and the use of A vitene in the splenic bed was successfully performed. Complete fixation of the spleen was confirmed by ultrasound a year after this procedure was carried out. The clinical pesentation, etiology, diagnostic procedures and management are discussed also.