Pediatric Splenic Volvulus

  • Etiology: Laxity of splenic ligaments leads to wandering spleen anywhere in abdomen or pelvis that can result in splenic torsion leading to splenic congestion or infarction or rupture
  • Imaging CT:
    — Ectopically located spleen which is not in the left upper quadrant
    — Splenic vascular pedicle has whirlpool configuration
    — Spleen may not enhance or only have peripheral enhancement
  • DDX:
  • Complications: Splenic congestion or infarction or rupture
  • Treatment: Surgical to detorse the spleen and perform splenoplexy
  • Clinical: Present with abdominal pain depending on degree of torsion

Radiology Cases of Splenic Volvulus

CT of splenic volvulus
Axial CT with contrast of the upper abdomen in the portal venous phase (above left) shows the spleen is absent from the left upper quadrant and is instead seen in the midline of the pelvis (above right). Coronal (below left) and sagittal (below right) CT in the delayed phase show the spleen to be in the midline of the pelvis above the bladder. The splenic vascular pedicle had a whirlpool appearance (not provided).