**5. Clinical pictures**

The diagnosis of wandering spleen is extremely difficult since it is such a rare condition and is clinically non-specific. In our recent multicenter study in children (Fiquet-François et al, 2010), we reported that the abdominal pain is at the forefront of all symptoms (93 % of cases), and its severity brings 86% of all cases to Emergency Room care. Furthermore, in 57% of all cases it was their first symptomatic episode of this type. The pain location is clinically non-specific: diffuse, periumbilical, left side, pelvis, left hypochondrium… Vomiting can be associated in 57% of cases. None of the diagnoses of wandering spleen were based on clinical evidence only. Even if the diagnosis cannot solely be based on clinical observations, it is important to note that the clinical presentation for wandering spleen can be either acute or chronic pain (Fiquet-François et al, 2010). The acute clinical pictures require emergency surgery because of the high risk of ischemia.
