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November 18, 1974

Torsion of the Spleen as a Rare Cause of Hypersplenism

Author Affiliations

From the departments of medicine (Drs. Weinreb and Forte), surgery (Dr. Bauer), and pathology (Dr. Dikman), Mount Sinai School of Medicine, New York.

JAMA. 1974;230(7):1015-1016. doi:10.1001/jama.1974.03240070049030

TORSION of the spleen is a rare event that is seldom suspected preoperatively. The symptoms may be acute and fulminant, mimicking appendicitis, cholecystitis, peritonitis, or intestinal obstruction. Less often, the manifestations are chronic, fluctuating vague pains, anorexia, and weight loss accompanied by an abdominal or pelvic mass. Confusion with ovarian disease or intra-abdominal tumors is common. Hypersplenism, if noted preoperatively, might direct diagnostic attention to the spleen, but it is rarely reported, even in retrospect. We describe a patient with splenomegaly and hypersplenism who, at laparotomy, was found to have torsion of the spleen.

Report of a Case  A 46-year-old woman was admitted to the gynecologic service of the Mount Sinai Hospital in May 1971, after four days of persistent, cramping, periumbilical and left-flank pain, anorexia, nausea, and occasional vomiting. Fourteen years previously, she had undergone right ovarian cystectomy and uterine myomectomy. The patient was well until five months before