Supplemental Material for: Pelvic Wandering Spleen with Splenic Infarction, Sigmoid Volvulus, and Hydronephrosis: A Case Report

Physical examination suggested diffuse tenderness in the lower abdomen. Laboratory investigations showed elevated inflammatory markers, including leukocytosis and elevated C-reactive protein, along with deranged liver function tests. Magnetic resonance imaging (MRI) revealed a pelvic spleen with evidence of complete infarction, as demonstrated by the absence of contrast enhancement and the classic “whirling sign” of twisted splenic vessels, indicative of torsion.

Additionally, imaging uncovered a sigmoid colon volvulus, left ovarian enlargement likely secondary to congestion, and left-sided hydronephrosis due to ureteral compression. The patient underwent an emergency laparotomy, during which a splenectomy, appendectomy, and decompression of the sigmoid colon were performed. Postoperative recovery was smooth, and the patient was discharged in stable condition with appropriate follow-up.</p><p dir="ltr"><b>Conclusion:</b><br>This case presents the role of cross-sectional imaging in diagnosing complex, multisystem abdominal emergencies.

Early detection and timely surgical intervention are paramount crucial in preventing debilitating outcomes, such as peritonitis or sepsis. The case adds to the limited literature by illustrating a rare presentation of WS complicated by simultaneous involvement of the splenic, gastrointestinal, urological, and gynecological systems, emphasizing the need for high clinical suspicion and multidisciplinary management in similar scenarios.<br><br></p>