Fig. 19.

A 17-year-old female patient presented to ER with abdominal pain. Abnormal position and anteromedial displacement of the spleen were noted on abdominal US (not shown). a Axial plane postcontrast abdominal CT showed global absence of contrast enhancement in the spleen parenchyma (asterisk), capsular rim enhancement (arrowheads), and «whirl sign» in the splenic pedicle (arrows). b Axial plane arterial phase image demonstrated a relative lack of enhancement in the splenic artery at the splenic pedicle (arrow). c Axial plane arterial phase maximum intensity projection image better demonstrated the focal cut-off in the twisted splenic artery (arrow). Imaging findings were compatible with global splenic infarction due to splenic torsion. Emergency laparotomy was performed, and histopathological examination of the torsed spleen revealed extensive coagulation necrosis with severe congestion