Solution: Wandering spleen is a rare pathology related to laxity or disruption of the splenic ligaments, and in this case was likely related in some way to the patients previous total colectomy. When the spleen moves out of its normal position, this can lead to torsion of the vascular pedicle with associated congestion and ischemia/infarction. Treatment is surgical and involves either splenopexy, or splenectomy. Diagnosis in this case hinges on noting that the spleen is not located in the LUQ, but rather is wedged into the region of the hepatic hilum and that there is associated infiltration around the vascular pedicle of the spleen.