Wandering Spleen with Torsion and Infarction T he spleen is in the midline with its hilum located postero-laterally, suggesting torsion. Multiple focal hypodense lesions are seen at the periphery suggesting infarction. A wandering spleen occurs with lax or absent ligamentous attachments. This predisposes to torsion about an elongated pedicle.
Torsion can then lead to infarction.
Identification of the spleen is not difficult when the anatomy is traced. Infarcts are seen as hypodense areas. Color Doppler US may help in assessing the status of flow in the splenic artery and vein. A pattern-oriented approach to splenic imaging in infants and children.