Wandering spleen: a rare and challenging diagnosis in pregnancy – a case report from Ethiopia

Introduction: Wandering spleen is a rare condition characterized by the abnormal displacement of the spleen, which can lead to potential complications including torsion and splenomegaly. With an incidence of less than 0.2% globally, its occurrence during pregnancy is particularly uncommon. Case Presentation: We present a 25-year-old Gravida-II, Para-I female from Ethiopia, who experienced a 10-day history of right upper quadrant abdominal pain, vomiting, nausea, and loss of appetite. Examination revealed a tender mass in the right upper quadrant, with ultrasound confirming splenomegaly and torsion of the spleen. The spleen was located atypically in the right upper quadrant, indicating a wandering spleen. Discussion: The wandering spleen's etiology includes congenital absence of supporting ligaments and acquired factors such as hormonal changes during pregnancy. Clinical manifestations can vary widely, complicating diagnosis, particularly during pregnancy. Imaging studies play a crucial role, and in this case, ultrasound findings were pivotal in preoperative diagnosis. Surgical intervention was necessary due to the complications of torsion. Conclusion: Wandering spleen presents significant clinical challenges, particularly in pregnant patients. Prompt diagnosis and surgical management are crucial to prevent severe outcomes. Post-splenectomy care includes vaccinations to guard against infections, underlining the importance of preventive measures following splenectomy.