Torsión esplénica: reporte de caso en paciente pediátrico

Wandering spleen is an uncommon condition caused by the absence or hyperlaxity of the splenic ligaments, allowing its displacement into the lower abdomen and leaving it suspended solely by its elongated vascular pedicle. This pathology can be asymptomatic or present with acute or chronic abdominal pain, depending on the extent of pedicle torsion and the degree of vascular compromise. We present the case of a 4-year-old pediatric patient who was admitted to the emergency department with an acute abdomen following abdominal trauma. During exploratory laparotomy, splenic pedicle torsion with splenic necrosis was identified, necessitating a splenectomy. The diagnosis was supported by imaging findings of splenomegaly and extensive subcapsular hemorrhage, while intraoperative analysis revealed a 12 cm spleen adhered to the gastrocolic omentum, with the absence of most splenic ligaments. Although splenopexy is the treatment of choice for viable spleens, in this case, splenectomy was required due to the organ's nonviability. This report emphasizes the importance of early diagnosis and timely surgical management to prevent complications associated with this rare condition. Keywords: Wandering spleen; splenic torsion; splenectomy; splenopexy; splenic ligaments; acute abdomen; abdominal trauma; splenomegaly; subcapsular hemorrhage; early diagnosis.