Splenic torsion in polysplenia syndrome: a rare cause of acute abdomen in a paediatric patient.

Acute abdominal pain in children presents a significant diagnostic challenge due to its broad differential, including rare congenital anomalies. Torsion of an accessory spleen is a rare but important cause, particularly in the context of polysplenia syndrome. We report the case of a 6-year-old boy with polysplenia syndrome who presented with severe abdominal pain, vomiting, and diarrhea. Imaging revealed multiple splenic masses, and exploratory laparotomy identified a torsed accessory spleen with a twisted vascular pedicle. Resection of the infarcted splenule and correction of associated intestinal malrotation were performed. The patient recovered uneventfully and was discharged on the third postoperative day. Splenic torsion in polysplenia syndrome should be considered in the differential diagnosis of acute abdomen in children with congenital anomalies. Prompt imaging and surgical intervention are essential for favourable outcomes, and increased awareness may aid in early diagnosis and management of this rare condition.