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Wandering spleen is a clinical entity which rarely affects children and adolescents. this condition can be asymptomatic or responsible of chronic pain, but it appears as a surgical emergency when an acute twisting occurs. the risk of post-splenectomy sepsis in the pediatric population suggests a conservative approach whenever possible, and also in case of acute torsion, most authors prefer to preserve the spleen and perform a splenopexy. the Authors describe a case of a child with acute splenic torsion, in whom a conservative surgical approach was initially adopted. the conservative option has to be balanced with the risk of prolonged thrombocytopenia, multiple transfusions and a possible second procedure to remove the spleen.
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