Last week a child with sudden abdominal pain that persisted for several days came to the clinic with very severe abdominal pain, pale face and a mass in the upper abdomen that was not allowed to be touched. After our examination, the diagnosis was: congenital free spleen combined with a torticollis. The spleen was not fixed by any ligament and had been twisted 3 times at the tip. The onset of the disease had been delayed for several days, resulting in delayed treatment, and the spleen was not only necrotic but also infected and septic. Her mother complained: 5 years ago, she found a mass in her abdomen and went to the doctor, who said it was fine, but since then she has had intermittent abdominal pain and has been treated for stomach problems. Now she thought that the mass was the spleen and the intermittent abdominal pain was torsion, but it was mild and did not attract attention. Although the incidence of congenital free spleen is extremely low, a mass in the abdomen must be examined early. Li Suning, Department of Pediatric Surgery, First Affiliated Hospital of Zhengzhou University