Cotes Claudia, Swischuk Leonard E
From the *Department of Radiology, and †Pediatric Radiology, The University of Texas Medical Branch, Galveston, TX.
Pediatr Emerg Care. 2013 Sep;29(9):1009-10. doi: 10.1097/PEC.0b013e3182a32079.
We present the clinical and imaging findings in a patient presenting with left upper quadrant pain. On plain films, a mass was seen in the left upper quadrant, and on computed tomography (CT), a spleen with a whorled pedicle suggesting torsion was identified. However, it was the coronal reconstruction CT study that definitely showed that the spleen had undergone a 180-degree torsion. We refer to the findings on the coronal CT reconstruction as the "upside down" spleen sign, and it was very helpful in clinching the diagnosis.
