case 39 full movie review

Log in or sign up for Rotten Tomatoes

Trouble logging in?

By continuing, you agree to the Privacy Policy and the Terms and Policies , and to receive email from the Fandango Media Brands .

By creating an account, you agree to the Privacy Policy and the Terms and Policies , and to receive email from Rotten Tomatoes and to receive email from the Fandango Media Brands .

By creating an account, you agree to the Privacy Policy and the Terms and Policies , and to receive email from Rotten Tomatoes.

Email not verified

Let's keep in touch.

Sign up for the Rotten Tomatoes newsletter to get weekly updates on:

• Upcoming Movies and TV shows
• Trivia & Rotten Tomatoes Podcast
• Media News + More

By clicking "Sign Me Up," you are agreeing to receive occasional emails and communications from Fandango Media (Fandango, Vudu, and Rotten Tomatoes) and consenting to Fandango's Privacy Policy and Terms and Policies . Please allow 10 business days for your account to reflect your preferences.

OK, got it!

Movies / TV

No results found.

• What's the Tomatometer®?
• Login/signup

Movies in theaters

• Opening this week
• Top box office
• Coming soon to theaters
• Certified fresh movies

Movies at home

• Fandango at Home
• Netflix streaming
• Prime Video
• Most popular streaming movies
• What to Watch New

Certified fresh picks

• Furiosa: A Mad Max Saga Link to Furiosa: A Mad Max Saga
• Young Woman and the Sea Link to Young Woman and the Sea
• Jim Henson Idea Man Link to Jim Henson Idea Man

New TV Tonight

• Star Wars: The Acolyte: Season 1
• Ren Faire: Season 1
• Clipped: Season 1
• Queenie: Season 1
• Sweet Tooth: Season 3
• Mayor of Kingstown: Season 3
• Criminal Minds: Season 17
• Becoming Karl Lagerfeld: Season 1
• Power Book II: Ghost: Season 4
• Erased: WW2's Heroes of Color: Season 1

Most Popular TV on RT

• Eric: Season 1
• Dark Matter: Season 1
• Evil: Season 4
• Tires: Season 1
• Outer Range: Season 2
• Star Wars: Ahsoka: Season 1
• Best TV Shows
• Most Popular TV
• TV & Streaming News

Certified fresh pick

• Star Wars: The Acolyte: Season 1 Link to Star Wars: The Acolyte: Season 1
• All-Time Lists
• Binge Guide
• Comics on TV
• Five Favorite Films
• Video Interviews
• Weekend Box Office
• Weekly Ketchup
• What to Watch

Star Wars TV Shows Ranked by Tomatometer

30 Most Popular Movies Right Now: What to Watch In Theaters and Streaming

What to Watch: In Theaters and On Streaming

6 TV and Streaming Shows You Should Binge-Watch in June 2024

The Acolyte First Reviews: A Familiar but New Vision of Star Wars , Packed with Stunning Action

• Trending on RT
• The Acolyte First Reviews
• Vote: 1999 Movie Showdown
• Bad Boys: Ride or Die

Where to Watch

Rent Case 39 on Fandango at Home, Prime Video, or buy it on Fandango at Home, Prime Video.

What to Know

Director Christian Alvert has a certain stylish flair, but it's wasted on Case 39 's frightless, unoriginal plot.

Critics Reviews

Audience reviews, cast & crew.

Christian Alvart

Renée Zellweger

Emily Jenkins

Jodelle Ferland

Lillith Sullivan

Ian McShane

Detective Mike Barron

Bradley Cooper

Kerry O'Malley

Margaret Sullivan

Movie Clips

More like this, related movie news.

Common Sense Media

Movie & TV reviews for parents

• For Parents
• For Educators
• Our Work and Impact

Or browse by category:

• Get the app
• Movie Reviews
• Best Movie Lists
• Best Movies on Netflix, Disney+, and More

Common Sense Selections for Movies

50 Modern Movies All Kids Should Watch Before They're 12

• Best TV Lists
• Best TV Shows on Netflix, Disney+, and More
• Common Sense Selections for TV
• Video Reviews of TV Shows

Best Kids' Shows on Disney+

Best Kids' TV Shows on Netflix

• Book Reviews
• Best Book Lists
• Common Sense Selections for Books

8 Tips for Getting Kids Hooked on Books

50 Books All Kids Should Read Before They're 12

• Game Reviews
• Best Game Lists

Common Sense Selections for Games

• Video Reviews of Games

Nintendo Switch Games for Family Fun

• Podcast Reviews
• Best Podcast Lists

Common Sense Selections for Podcasts

Parents' Guide to Podcasts

• App Reviews
• Best App Lists

Social Networking for Teens

Gun-Free Action Game Apps

Reviews for AI Apps and Tools

• YouTube Channel Reviews
• YouTube Kids Channels by Topic

Parents' Ultimate Guide to YouTube Kids

YouTube Kids Channels for Gamers

• Preschoolers (2-4)
• Little Kids (5-7)
• Big Kids (8-9)
• Pre-Teens (10-12)
• Teens (13+)
• Screen Time
• Social Media
• Online Safety
• Identity and Community

Real-Life Heroes on YouTube for Tweens and Teens

• Family Tech Planners
• Digital Skills
• All Articles
• Latino Culture
• Black Voices
• Asian Stories
• Native Narratives
• LGBTQ+ Pride
• Best of Diverse Representation List

Multicultural Books

YouTube Channels with Diverse Representations

Podcasts with Diverse Characters and Stories

Common sense media reviewers.

Dull "killer kid" tale features violence involving children.

A Lot or a Little?

What you will—and won't—find in this movie.

The movie suggests that evil lurks everywhere, eve

Emily is a social worker who ostensibly wants to h

Some violence involving children, including a sequ

Some flirting between grown-ups.

A couple of uses of "f--k" and "s--

Characters drink Heineken beer in a bar.

Adults drink a beer in a bar, and the main charact

Parents need to know that Case 39 is part of the "killer children" horror subgenre, in which children are shown to be evil and homicidal; it's a psychologically effective and scary idea, but this movie is mainly out for shocks rather than exploring anything deeper. There's lots of…

Positive Messages

The movie suggests that evil lurks everywhere , even in the sweetest and most innocent of children. You can't trust anybody or anything, and there's never any attempt to learn anything, to turn things around for the better, or to find hope in the world.

Positive Role Models

Emily is a social worker who ostensibly wants to help children, but this doesn't come from a place of generosity. She's frustrated and stressed and apparently incapable of forming any meaningful relationships of her own. She's short and abrupt with people and quick to mistrust them. Once she decides that the child is evil, she never really tries to help; her first impulse is to try to kill the child.

Violence & Scariness

Some violence involving children, including a sequence in which two parents push a girl into an oven and light it. She escapes, but the father pushes his boot into her back to stop her. They duct tape her mouth and smash her hand in the oven door. In another sequence, a boy kills his parents with a tire iron, though no actual "contact" is shown; viewers see blood on the walls and pillows. Adults fight: Viewers see a man with a broken jaw, a man gets stabbed in the neck with a fork, and another man falls on the same fork (it impales him in the eye). Also images of a woman on fire, a dog attack, shooting guns, a speeding car (with a child on board), a burning house, scary demons, and several sudden shocks.

Did you know you can flag iffy content? Adjust limits for Violence & Scariness in your kid's entertainment guide.

Sex, Romance & Nudity

Did you know you can flag iffy content? Adjust limits for Sex, Romance & Nudity in your kid's entertainment guide.

A couple of uses of "f--k" and "s--t," plus "hell," "ass," and "oh my God."

Did you know you can flag iffy content? Adjust limits for Language in your kid's entertainment guide.

Products & Purchases

Drinking, drugs & smoking.

Adults drink a beer in a bar, and the main character enjoys a glass of wine at home. The main character also grinds up sleeping pills into a cup of tea to give to the demon child.

Did you know you can flag iffy content? Adjust limits for Drinking, Drugs & Smoking in your kid's entertainment guide.

Parents Need to Know

Parents need to know that Case 39 is part of the "killer children" horror subgenre, in which children are shown to be evil and homicidal; it's a psychologically effective and scary idea, but this movie is mainly out for shocks rather than exploring anything deeper. There's lots of violence, including some scenes involving children (in one particularly disturbing sequence, adults push a girl into an oven and light it), as well as other deaths and injuries. Language includes a few uses of "f--k" and "s--t," while sex, drinking, and drugs aren't prevalent. To stay in the loop on more movies like this, you can sign up for weekly Family Movie Night emails .

Where to Watch

Videos and photos.

Community Reviews

• Parents say (5)
• Kids say (23)

Based on 5 parent reviews

Another edge of your seat movie

Worth watching..., what's the story.

Stressed social worker Emily Jenkins ( Renee Zellweger ) is assigned one more case in addition to the 38 she already has, a young girl named Lilith ( Jodelle Ferland ). Emily visits the home and discovers that the girl's parents are showing signs of abuse. Emily decides to take Lilith in until a good foster home can be found -- but unfortunately, everyone around Emily quickly begins dying, starting with her psychologist friend, Doug ( Bradley Cooper ). Emily starts to believe that maybe Lilith is the problem, rather than her parents. Can she get anyone to believe her before it's too late?

Is It Any Good?

The "demon child" subgenre of horror movies is an old one, stretching from The Bad Seed to The Omen to the more recent Orphan , and Case 39 doesn't have anything fresh to add. Completed in 2007, CASE 39 sat around for a long time before being unceremoniously dump in theaters in 2010; in the meantime, director Christian Alvart went on to make the effectively moody Pandorum , but this movie is a dud.

In these movies, the horror springs from the concept that the purest and most innocent of all creatures -- a child -- can harbor murderous evil. But Case 39 doesn't seem to understand this; there's no real emotional draw to the characters, and they don't seem connected to one another. Alvart counts on jump shocks and sudden noises for his scary scenes, and none of it works very well. The movie never digs deeper into its premise.

Talk to Your Kids About ...

Families can talk about the movie's violence . How did it affect you? Why do you think it affected you that way?

As a horror movie, is Case 39 scary ? Which scenes worked the best? In general, what's scarier -- blood and gore, or long, slow build-ups?

What makes "killer kids" like Lilith scary?

Movie Details

• In theaters : October 1, 2010
• On DVD or streaming : January 4, 2011
• Cast : Bradley Cooper , Ian McShane , Jodelle Ferland , Renee Zellweger
• Director : Christian Alvart
• Inclusion Information : Female actors
• Studio : Paramount Vantage
• Genre : Horror
• Run time : 109 minutes
• MPAA rating : R
• MPAA explanation : violence and terror including disturbing images
• Last updated : May 20, 2024

Did we miss something on diversity?

Research shows a connection between kids' healthy self-esteem and positive portrayals in media. That's why we've added a new "Diverse Representations" section to our reviews that will be rolling out on an ongoing basis. You can help us help kids by suggesting a diversity update.

Suggest an Update

Our editors recommend.

The Orphanage

Best horror movies, scary movies for kids.

Common Sense Media's unbiased ratings are created by expert reviewers and aren't influenced by the product's creators or by any of our funders, affiliates, or partners.

Notice: All forms on this website are temporarily down for maintenance. You will not be able to complete a form to request information or a resource. We apologize for any inconvenience and will reactivate the forms as soon as possible.

• DVD & Streaming

Content Caution

In Theaters

• October 1, 2010
• Renée Zellweger as Emily Jenkins; Jodelle Ferland as Lilith Sullivan; Ian McShane as Detective Barron; Bradley Cooper as Doug

Home Release Date

• January 4, 2011
• Christian Alvart

Distributor

• Paramount Vantage

Movie Review

Emily Jenkins is a child services officer who really cares. And that’s not always so easy to do. The state buries her under an incredibly heavy caseload, leaving her little time to have a life of her own. And sometimes those kids can be a real handful.

But it’s worth it.

Let’s face facts: There’s usually a good reason for children to start acting out in public. And it often begins at home. If Emily can just uncover the truth in each case she gets, she can make a difference.

Emily’s case number 39 is … well, it’s a case in point. Lilith Sullivan, a slight, cow-eyed 10-year-old is the epitome of a wounded kid cowering quietly in the shadows. Emily wants to protect her from the moment she sees her. And the girl’s crazy-looking parents only strengthen her resolve.

And that’s when the mom and dad attempt to bake their young daughter to death in a taped-shut oven.

The parents are sent away, and Emily determines to take little Lilith under her own protective wing. But disturbing things begin to happen. Things are bumping in the night. People around Emily are dying mysteriously. And little Lilith seems to be changing in odd ways. All of a sudden Emily starts wondering if, this time, the mom and the dad were the ones with the good reason for acting out.

Positive Elements

As stated, Emily is dedicated to helping kids. She’s gentle and caring and does her best to show parents how wise choices at home can calm a troubled child’s stormy seas. Emily fears that because her mother did such a lousy job raising her, she would be a bad parent, too. But that doesn’t stop her from going out of her way to bring the battered Lilith into her home and show the child love.

Emily’s police friend Mike is willing to help Emily for the sake of the kids—even though his department frowns on some of Emily’s extracurricular requests.

Emily voices her love for Lilith.

Spiritual Elements

Without putting too fine a point on it, this is a film about a young girl who is, in reality, a demon. And near the end of the film we see her take on her true demonic form.

Both of Lilith’s parents state that it’s “God’s will” that Lilith die. And Mr. Sullivan says that Lilith was born with a demon’s soul that feeds on “kindness and decency.” When Emily asks him what the creature wants, he replies, “To know what your idea of hell is, and make you live in it.”

In Lilith’s house, crosses adorn many of the walls. Emily flips through a Bible in Lilith’s room.

Sexual Content

Emily wears a few shirts that have a few too many buttons open. During one fright scene, she runs down the street wearing a skimpy T-shirt and shorts in the rain. A shot of a rap video on TV shows a buxom woman dressed in shorts and a brief bikini top.

Emily suggests to her friend Doug that his choice of becoming a psychologist was “just about scoring chicks, right?” Doug jokingly agrees and then offers Emily a purely physical relationship if a “real” one is too much for her right now.

Violent Content

This is a movie about a demonic entity that can, with a few whispered words, cause people to see twisted visions and eventually commit horrific acts while in a state of panic. Examples include:

A young boy is driven to beat his parents to death while they sleep. We see him swinging a crowbar, blood splashing the walls and, later, the grisly, gore-encrusted bed. Another scene focuses on a guy pulling a hornet out of his ear and eventually being enveloped by stinging insects that pour out of every orifice. He lacerates his face when stumbling through a shower door and falls, viciously snapping his neck.

A man has his face savagely smashed into a refrigerator door. And we see his shattered jaw hanging broken and askew. A woman who envisions herself burning alive flails around while tearing at the skin on her face and arms. A man brutally jams a fork into another man’s neck and then slashes at several others until he trips and plunges the utensil into his own eye. A dog bites a man in the neck and, while trying to defend himself, the victim shoots off half of his face with a shotgun blast.

Parents forcefully cram a girl into a gas oven and turn up the flames. Then they attack the girl’s defenders with a knife. A woman splashes gasoline around the interior of her home and sets the house ablaze. Later, she holds a struggling child underwater in an attempt to drown her.

Crude or Profane Language

Two f-words and three s-words. Also a few uses each of “h‑‑‑” and “a‑‑.” God’s name is misused once or twice.

Drug and Alcohol Content

Emily and Doug have beers at a bar. Emily drinks wine at home. Emily also gets a sleeping pill prescription and grinds several pills into Lilith’s tea.

Other Negative Elements

Lilith lies on a number of occasions and verbally manipulates adults around her.

While not my favorite genre, I understand how some people can really get into scary flicks. But even fans should admit that a horror movie will rarely have much of anything redeeming to offer you by the time the credits roll. I mean, even if the central character somehow lives through it all (and I’m not saying whether that is or isn’t the case here), the gruesome messiness or twisted spirituality that usually gets you to the last frame will inevitably be none too uplifting.

So what else is there to discuss? Well, there are a few other basic questions that we reviewers generally ask—even when it comes to horror flicks:

1) Does it have some deeper meaning about our lives or the world we live in?

2) Is it a well-directed piece that deftly carries us into a creative story with style?

3) Last, and very definitely least, does it make you jump and clutch your date’s hand?

With Case 39—a film that was delayed for more than two years before its release—the answer to all those questions is simple and direct: nope.

After spending more than two decades touring, directing, writing and producing for Christian theater and radio (most recently for Adventures in Odyssey, which he still contributes to), Bob joined the Plugged In staff to help us focus more heavily on video games. He is also one of our primary movie reviewers.

Latest Reviews

Bad Boys: Ride or Die

Young Woman and the Sea

Back to Black

The Fall Guy

Weekly reviews straight to your inbox.

Review by Brian Eggert October 3, 2010

In the realm of evil child movies such as, most recently, Orphan , the dull supernatural thriller Case 39 does a disservice to the sometimes entertaining horror subgenre. Completed in 2006, the movie was shelved by Paramount stateside but distributed overseas where moderate box office performance justified its much-belated U.S. release just a few weeks before Halloween. But curious moviegoers and even horror fanatics won’t find much to savor in this laughable, often overwrought scenario, where a seriously bad youth turns the tables on unsuspecting adults.

Sour-faced social worker Emily (Renée Zellweger) probes into the thirty-ninth file on her cluttered cubicle to find the withdrawn, would-be innocence of little girl Lilly (Jodelle Ferland). Upon further investigation during an in-home interview with the weirdo parents, Emily comes to believe that Lilly is being abused; but without any evident bruises, she can’t be sure. Then Lilly whispers, “They said they’re going to send me to Hell.” That would be a good indicator, except what if the parents have good reason to send their child to Hell? But instead of questioning why the parents want to dispose of their child in their kitchen oven, Emily enlists her trusty cop friend (Ian McShane) to burst down their front door and save the girl from certain doom.

Despite help from child psychologist and almost-boyfriend Doug (Bradley Cooper, in The Midnight Meat Train mode), Emily quickly regrets her hasty decision to fight for foster rights to Lilly. It seems people have a curious habit of dying around the girl in freak accidents and unmotivated murders, which occur after Lilly rings them with a devil-tongued telephone call. And when Doug meets his demise after he confesses to Emily that he was “threatened” by Lilly, our protagonist finally begins to suspect what the audience has known for half the movie. Lilly is evil. Though, we’re not sure at first if her brand of evil is supernatural (like The Omen ) or just a good old-fashioned case of personality disorder (see Joshua ).

As it turns out, Lilly is Satan or a demon of some kind; though the movie is never clear on this point. Rather than give the audience some inkling, the script by The Crazies writer Ray Wright plays with the irony of battered parents by the hands of a powerful child, but that stroke of cleverness grows old the moment we discover (in the vague way we do) Lilly’s demonic origins. So the movie becomes a horror show where Lilly holds incredible supernatural power over the good-intentioned Emily, creating phantom sounds and frightening situations as a tormentor. There’s an illusion where an elevator is falling, a shrug-worthy scene involving hornets, and one where Emily is being chased through the rain by a zombified burn victim. Emily seems terrified by it all. Pity the audience doesn’t feel the same.

Throwaway roles by Cooper and McShane somehow prove more interesting than Zellweger’s puckered performance, which quickly goes from caring pseudo-mother to arm-pulling deadbeat foster mom. Who can blame her though, when her foster daughter is a demon? Zellweger has an Oscar, but even reminding yourself of that won’t help her frustratingly dense character seem any more interesting. On the other hand, a horror veteran at 16 years old, Ferland (who was twelve when the movie was shot) steals the show as the sharp-witted, slyly evil youngster. The Silent Hill and Tideland star seems typecast into bizarro-children roles, but perhaps that’s because she performs them so well.

This makes the second grossly underwhelming Hollywood genre picture for German director Christian Alvart. Shot before his 2009 sci-fi/horror flop Pandorum , Case 39 offers little by way of storytelling ingenuity, and the trailers only make the movie’s release troubles worse. Viewers will notice scenes in the trailer (one where Lilly falls through the center of her bed, for example) that do not appear in the finished film, suggesting Paramount finally whipped together the footage to get the thing off their shelves. Well, now that it’s off their shelves, both the studio and the audience can move on and forget this unmemorable dud altogether.

Related Titles

The Definitives

• In Theaters

Recent Reviews

• Hit Man 3.5 Stars ☆ ☆ ☆ ☆
• Short Take: Night Shift 3 Stars ☆ ☆ ☆
• Young Woman and the Sea 3 Stars ☆ ☆ ☆
• The Dead Don't Hurt 3.5 Stars ☆ ☆ ☆ ☆
• In a Violent Nature 3.5 Stars ☆ ☆ ☆ ☆
• Handling the Undead 2.5 Stars ☆ ☆ ☆
• Patreon Exclusive: The Prestige 3 Stars ☆ ☆ ☆
• Furiosa: A Mad Max Saga 4 Stars ☆ ☆ ☆ ☆
• Patreon Exclusive: The Strangers: Chapter 1 1 Star ☆
• Babes 3 Stars ☆ ☆ ☆
• Evil Does Not Exist 4 Stars ☆ ☆ ☆ ☆
• Coma 3.5 Stars ☆ ☆ ☆ ☆
• Nightwatch: Demons Are Forever 3.5 Stars ☆ ☆ ☆ ☆
• I Saw the TV Glow 3 Stars ☆ ☆ ☆
• The Last Stop in Yuma County 3 Stars ☆ ☆ ☆

Recent Articles

• The Definitives: Contagion
• Guest Appearance: The LAMBcast - Decade Lookback 1998
• Guest Appearance: KARE 11 - Summer Movie Preview
• Guest Appearance: The LAMBcast - The Fall Guy
• The Definitives: Paris, Texas
• Reader's Choice: Saturday Night Fever
• MSPIFF 2024 – Dispatch 4
• MSPIFF 2024 – Dispatch 3
• Guest Appearance: KARE 11 - 3 movies you need to see in theaters now
• MSPIFF 2024 – Dispatch 2

Streaming in:

We checked for updates on 249 streaming services on June 5, 2024 at 8:13:21 PM. Something wrong? Let us know!

Case 39 streaming: where to watch online?

Currently you are able to watch "Case 39" streaming on Paramount Plus Apple TV Channel , Hoopla, Showtime Apple TV Channel. It is also possible to buy "Case 39" on Apple TV, Amazon Video, Google Play Movies, YouTube, Vudu, Microsoft Store, AMC on Demand as download or rent it on Microsoft Store, Amazon Video, Apple TV, Google Play Movies, YouTube, Vudu online.

Where does Case 39 rank today? The JustWatch Daily Streaming Charts are calculated by user activity within the last 24 hours. This includes clicking on a streaming offer, adding a title to a watchlist, and marking a title as 'seen'. This includes data from ~1.3 million movie & TV show fans per day.

Streaming charts last updated: 9:11:34 PM, 06/05/2024

Case 39 is 1812 on the JustWatch Daily Streaming Charts today. The movie has moved up the charts by 595 places since yesterday. In the United States, it is currently more popular than Severed Ways: The Norse Discovery of America but less popular than Carlito's Way.

In her many years as a social worker, Emily Jenkins believes she has seen it all, until she meets 10-year-old Lilith and the girl's cruel parents. Emily's worst fears are confirmed when the parents try to harm the child, and so Emily assumes custody of Lilith while she looks for a foster family. However, Emily soon finds that dark forces surround the seemingly innocent girl, and the more she tries to protect Lilith, the more horrors she encounters.

Videos: Trailers, Teasers, Featurettes

Streaming Charts The JustWatch Daily Streaming Charts are calculated by user activity within the last 24 hours. This includes clicking on a streaming offer, adding a title to a watchlist, and marking a title as 'seen'. This includes data from ~1.3 million movie & TV show fans per day.

Production country

People who liked case 39 also liked.

Popular movies coming soon

Similar Movies you can watch for free

• Celebrities
• Secret Invasion
• The Marvels
• Disney Plus
• Apple TV Plus
• Dwayne Johnson
• Brie Larson
• Ryan Reynolds
• The Witcher
• About & Advertising
• Affiliate Policy
• Privacy Policy

Case 39 Review

Minimally creepy and all too conventional, Case 39 finally makes its way into theatres. The movie was filmed a couple years ago (2006) and for some reason it is only now seeing the light of day, in US theatres at least. Starring Renee Zellweger and Bradley Cooper (before he was a huge star), Case 39 really doesn’t do a whole lot that we haven’t already seen.  It’s not particularly scary, it’s in no way original or innovative, it’s awkwardly predictable and to be honest, there’s not much I can think of in terms of reasons to see this film. Of course there’s the token ‘creepy and disturbed’ child, played fairly well by Jodelle Ferland, but aside from that, the film doesn’t offer much.

Case 39 tells the story of Emily Jenkins (Renee Zellweger), a social worker who is assigned to investigate the Sullivan family. Emily suspects that Mr. and Mrs. Sullivan are abusing their daughter Lillith. Emily’s suspicions seem to be confirmed when Mr. and Mrs. Sullivan attempt to murder Lillith.

Luckily their plan doesn’t work and Emily is able to intervene. She takes Lillith into her own home and starts to care for her. Pretty soon strange events begin to occur and Emily starts to fear that Lillith may not be entirely normal. As the movie progresses, Emily finds herself in a situation that is far more dangerous than she bargained for.

As mentioned before, everything in Case 39 just feels so routine. In such an over crowded genre, Case 39 really does nothing to stand out. It’s not an especially terrible film, there are a few genuinely creepy moments, but you still have to wonder, why would Case 39 even both with theatres, why not head right to disc?

Director Christian Alvart takes a bit of a heavy handed approach behind the camera and his direction is uninspired. He takes pages out of many other horror films and he doesn’t do anything particularly unique or interesting. The ‘evil child’ story has been done to death and putting out yet another rehash on the tale is a bit of an audacious move, at least give us something fresh.

The supposedly grisly death scenes all have little to no effect on the audience as they were all seen from a mile away. Everything is predictable and nothing shocks or surprises. The film also suffers from some dull production values and isn’t very well polished.

To make matters worse, most of the cast saunters through the film and no one is particularly engaging. Ian McShane, who plays one of Emily’s colleagues, looks as confused as to why he’s in the film as we are. A usually very capable actor, he makes his way through the film giving a less than average performance.

Cooper, who wasn’t yet a star at this point, gives an honest effort but is still far from the Cooper we saw in The Hangover . Zellweger isn’t much better either, her performance is adequate for the film but like the others, it won’t turn heads.

In the end, Case 39 is just very mediocre, and with so many superb films out right now, there really isn’t much reason to see this conventional horror flick. As stated before, it’s not the worst horror movie out there, it’s just not original or unique in anyway and the predictability and conventionality make for a somewhat boring movie going experience.

Case 39 (2009) Stream and Watch Online

Watch 'case 39' online.

Want to behold the glory that is ' Case 39 ' on your TV or mobile device at home? Searching for a streaming service to buy, rent, download, or view the Christian Alvart-directed movie via subscription can be challenging, so we here at Moviefone want to take the pressure off. Read on for a listing of streaming and cable services - including rental, purchase, and subscription options - along with the availability of 'Case 39' on each platform when they are available. Now, before we get into the various whats and wheres of how you can watch 'Case 39' right now, here are some details about the Paramount Vantage, Misher Films, Anonymous Content, Case 39 Productions horror flick. Released August 13th, 2009, 'Case 39' stars Renée Zellweger , Jodelle Ferland , Ian McShane , Bradley Cooper The R movie has a runtime of about 1 hr 49 min, and received a user score of 63 (out of 100) on TMDb, which assembled reviews from 2,152 knowledgeable users. Want to know what the movie's about? Here's the plot: "In her many years as a social worker, Emily Jenkins believes she has seen it all, until she meets 10-year-old Lilith and the girl's cruel parents. Emily's worst fears are confirmed when the parents try to harm the child, and so Emily assumes custody of Lilith while she looks for a foster family. However, Emily soon finds that dark forces surround the seemingly innocent girl, and the more she tries to protect Lilith, the more horrors she encounters." 'Case 39' is currently available to rent, purchase, or stream via subscription on Google Play Movies, Vudu, Apple iTunes, Microsoft Store, AMC on Demand, Paramount Plus Apple TV Channel , YouTube, Amazon Video, Showtime Apple TV Channel, and Hoopla .

'Case 39' Release Dates

Similar movies.

Featured News

Movie Reviews

Follow Moviefone

Latest trailers.

• Movies & TV Shows
• Most Popular
• Leaving Soon
• Descriptive Audio
• Documentary
• Browse Channels

Featured Channels

• Always Funny
• History & Science
• Sci-Fi & Action
• Chills & Thrills
• Nature & Travel
• Black Entertainment
• Kids & Family
• International
• Gaming & Anime

• Boston Globe Ethan Gilsdorf It's a bummer when the audience is smarter than the protagonist.
• Entertainment Weekly Chris Nashawaty An aggressively inept demon-seed chiller starring a bunch of grown-ups who should've known better.
• Los Angeles Times Robert Abele [Plays] like one more piece of multiplex in-box clutter, ready for the circular file in our moviegoing consciousness.
• New York Times Jeannette Catsoulis By the time the killings start, it's clear that Ray Wright's screenplay is more interested in following formula than in breaking new ground.
• Reel Talk Online Candice Frederick Almost identical to 2009's Orphan, Case 39 does little keep your attention as its riddled with cliches--menacing music, domino casualties, and predictable horror plotline.
• Slant Magazine Rob Humanick This supernaturally tinged tale only goes skin-deep and is proud of it, wasting little time in establishing narrative basics and getting to the good stuff.
• Austin Chronicle Marc Savlov Neither so awful as to be enjoyable nor eerily artful enough to be anything other than a snoozy also-ran.
• HollywoodChicago.com Brian Tallerico Miscast, poorly-directed, and just-plain boring, Case 39 never clicks into place.
• Hollywood Reporter Frank Scheck The devil made them do it, but that doesn't mean you have to see it.
• Variety Jordan Mintzer This ludicrous outing from helmer Christian Alvart and scribe Ray Wright takes its psycho-satanic babble much too seriously, and should elicit more laughs than frights.
• Examiner.com Jeff Beck While it's able to pull you in at some points with its eerie mood, it needed a lot more originality and better scares than the cheap kind of just having things pop up out of nowhere.
• Sacramento News & Review Jim Lane ... before the movie is half over, the usual cliches take over ...
• Movie Nation Roger Moore The end of Zellweger as we've known her.
• Reel Film Reviews David Nusair ...a decent little horror flick...
• Movie Metropolis John J. Puccio ...we get a couple of moments of genuine suspense combined with a whole lot of cheap thrills.
• We Got This Covered Matt Joseph Despite its initial premise showing promise, Case 39 turns out to be boring, predictable and nothing new.
• KWQC-TV (Iowa) Linda Cook What do you do with a crummy horror movie that has been sitting on the shelf for a couple, or maybe three, years?
• FEARnet Scott Weinberg What starts out as slight and fairly obvious turns into a frequently colorful horror tale.
• Movies.com Dave White [A] dumb thriller.
• IGN DVD R.L. Shaffer Not only is Case 39 deplorable and morally off-center, the film is dull to boot.

Take Plex everywhere

• Rent or buy
• Categories Categories
• Getting Started

Cast and Crew

Other formats

2224 global ratings

How are ratings calculated? Toggle Expand Toggle Expand

• Amazon Newsletter
• About Amazon
• Accessibility
• Sustainability
• Press Center
• Investor Relations
• Amazon Devices
• Amazon Science
• Sell on Amazon
• Sell apps on Amazon
• Supply to Amazon
• Protect & Build Your Brand
• Become an Affiliate
• Become a Delivery Driver
• Start a Package Delivery Business
• Advertise Your Products
• Self-Publish with Us
• Become an Amazon Hub Partner
• › See More Ways to Make Money
• Amazon Visa
• Amazon Store Card
• Amazon Secured Card
• Amazon Business Card
• Shop with Points
• Credit Card Marketplace
• Reload Your Balance
• Amazon Currency Converter
• Your Account
• Your Orders
• Shipping Rates & Policies
• Amazon Prime
• Returns & Replacements
• Manage Your Content and Devices
• Recalls and Product Safety Alerts
• Conditions of Use
• Privacy Notice
• Consumer Health Data Privacy Disclosure
• Your Ads Privacy Choices

• Stranger Things Season 5
• Deadpool and Wolverine
• The Batman 2
• Spider-Man 4
• Yellowstone Season 6
• Fallout Season 2
• The Last of Us Season 2

Entertainment

Movie reviews, TV Show recaps, previews, and news about all of the latest happenings in Entertainment, delivered with the tech-focused expertise you expect.

How to get Paramount Plus and Showtime for $5 from Sling TV

Everything you need to know about alien: romulus, everything you need to know about the last of us season 2, get a month of paramount+ for $5 with this sling tv deal, video game adaptation watch dogs finds its two lead stars, this sling tv deal gets you a month of starz for $5, like a simple favor then watch these 3 netflix movies now, the best shows on max (formerly hbo max) right now, will deadpool & wolverine’s shawn levy direct avengers 5, the best lgbtq movies on netflix right now, braves vs red sox live stream: can you watch for free, venom 3: release date, plot, cast, trailer, and more, maxxxine trailer: mia goth becomes a star, if you have to watch one hulu movie in june 2024, stream this one, 10 best historical movies ever, ranked, the 10 most popular tv shows on netflix right now, hurry sling orange and sling blue are both down to $20 right now, grab this sling tv deal to watch the nba finals for just $20, get paramount+, amc+, mgm+ and starz for free with this sling tv deal, the 10 most popular movies on netflix right now, 3 reasons to watch patrick melrose on netflix, the best stand-up comedy on netflix right now, alien: romulus trailer teases more face-hugging madness, the acolyte review: a refreshing change of pace, a24 to rerelease x in theaters, give a sneak peek at maxxxine, 10 best star wars shows ever, ranked, philo adds amc+ to bundled plan, expands fast offering to non-subscribers, 10 best romance movies of all time, ranked, snowpiercer season 4 teaser trailer previews one last ride, paramount+ celebrates pride month 2024 with special collection of movies and tv shows, the 10 most popular shows on max right now, 10 worst tv show adaptations, ranked, tom hardy’s symbiote prepares for one final mission in venom: the last dance trailer, 10 best alfred hitchcock movies, ranked.

• Comic Book Movies
• Comic-Con: Complete Coverage
• How to Watch
• Stranger Things

Entertainment News

Entertainment features, in a violent nature’s chris nash on creating the most disturbing horror movie ever made, this forgotten 2009 movie is a modern horror classic. here’s why you should watch it (if you can), is furiosa a worthy follow-up to mad max: fury road, game of thrones’ disappointing finale lost sight of what made the series so great, now is the perfect time to start watching doctor who, it’s time to leave netflix’s binge-release model behind for good, x-men ’97 shows that marvel and the mcu are moving in the right direction, how tech powers the sensory-friendly screenings that open theaters to everyone, entertainment guides, entertainment reviews, in a violent nature review: an old-fashioned gorefest, updated, furiosa: a mad max saga review: a thrilling new trip down fury road, atlas review: an absurd netflix sci-fi movie that works as a guilty pleasure, the strangers: chapter 1 review: a dull horror retread, doctor who review: a promising era, but a rocky start, kingdom of the planet of the apes review: a great, thoughtful sci-fi sequel, the fall guy review: a near-perfect summer blockbuster.

Jason is a writer, editor, and pop culture enthusiast whose love for cinema, television, and cheap comic books has led him to work in the entertainment industry. A proud graduate of both Whitman College (Adam West’s alma mater!) and Syracuse University, he has worked at Marvel Entertainment, DC Comics, Warner Bros., and Screen Rant. At Digital Trends, he covers all things film and television, from ranking Alfred Hitchcock’s best films to examining the everlasting neuroses of Larry David.  When he’s not obsessing over the latest Marvel Studios trailer, you can find him either working or surfing the web looking for the perfect fudge brownie recipe.

Advertisement

Supported by

‘Hitler and the Nazis’ Review: Building a Case for Alarm

Joe Berlinger’s six-part documentary for Netflix asks whether we should see our future in Germany’s past.

• Share full article

By Mike Hale

Hitler’s project: “Making Germany great again.” The Nazis’ characterization of criticism from the media: “Fake news.” Hitler’s mountain retreat in Berchtesgaden: “It’s sort of like Hitler’s Mar-a-Lago, if you will.”

Donald Trump’s name is not mentioned in the six episodes of “Hitler and the Nazis: Evil on Trial,” a new historical documentary series on Netflix. But it dances just beneath the surface, and occasionally, as in the examples above, the production’s cadre of scholars, popular historians and biographers can barely stop themselves from giving the game away.

The series was directed by the veteran documentarian Joe Berlinger (“Paradise Lost,” “Metallica: Some Kind of Monster”), who has a production deal with Netflix and has given it popular true-crime shows like “Jeffrey Epstein: Filthy Rich” and the “Conversations With a Killer” series.

In promotional material, Berlinger explains his decision to step up from true crime to total war and genocide: “This is the right time to retell this story for a younger generation as a cautionary tale,” he says, adding, “In America, we are in the midst of our own reckoning with democracy, with authoritarianism knocking at the door and a rise in antisemitism.” In other words, you can’t make a documentary about Germany in the 1930s and ’40s without holding the United States of the 2010s and ’20s in your mind.

To that end, Berlinger has made a deluxe version of the sort of history of Hitler, the Third Reich and the Holocaust that for years has been a staple of American cable television. The information is not new, but the resources available to Berlinger are reflected in the abundance of material he deploys across nearly six and a half hours: archival film, most of it meticulously colorized for the series, and audio; staged recreations with a sprawling cast of actors; and the copious roster of interviewees.

A new telling of an old story requires a twist, of course, and Berlinger has several. The American journalist William L. Shirer serves as the series’s unofficial narrator, despite having died in 1993 — an A.I. recreation of his voice recites passages from his many books about the period, and occasionally his actual voice is heard in excerpts from radio broadcasts. He is also represented onscreen by an actor in scenes recreating the series’s other primary framing device, the first Nuremberg trials in 1945.

Testimony from the trials is used to fill in the show’s accounts of political machinations, war making and mass killing. And the presentation of the trials is the most striking example of a visual style Berlinger employs throughout the series: sliding smoothly back and forth between elaborately staged recreations and real colorized footage, so that you need to pay attention to know whether you are looking at Hermann Goering or the actor playing Hermann Goering (Gabor Sotonyi). Berlinger is going for a seamless dramatic effect, and if it doesn’t always work as drama, it holds your attention.

Even the interviews are theatrical, shot on a darkened stage with blood-red curtains framing a ladder and what looks like a rough brick wall. It is unclear what the set dressing is meant to represent, but it might reflect Berlinger’s demonstrated tendency toward a kind of hushed sensationalism in the service of storytelling. That impulse comes through more clearly in some of the recreation, such as a scene of Jewish captives being shot at Babi Yar, or in the way the actor silently playing Hitler, Karoly Kozma, has been directed to play many of his scenes as if he were mid-seizure.

Much of the familiar material of a World War II documentary is missing or mentioned in passing, with events on the western front getting cursory attention. Berlinger is concerned with the development of Hitler’s psychology and worldview, and that takes the series on a track from the frustrations of his youth in Austria to his rise in 1930s Germany, and from there to the eastern front, the Soviet Union and the concentration camps in Germany and Poland.

The focus is on how the personal drives the political, and you can’t watch “Evil on Trial” without considering how Berlinger’s and his colleagues’ feelings about Trump and the hard right in the contemporary United States might have affected what they chose to emphasize in their portrait of Hitler and Nazi Germany.

But the unspoken case they build is comprehensive. We are shown Hitler tapping into the emotions stirred by a nation’s loss of power; playing to people who feel economically exploited and alienated from a liberal, urban culture; and uniting moderate and radical conservatives in fear of the far left. We see him demanding absolute loyalty and pitting subordinates against one another in battles for his favor. We see an absence of empathy and an inability to admit defeat. Shirer chimes in: “I began to comprehend it did not matter so much what he said, but how he said it. In such an atmosphere, every lie pronounced is accepted as high truth itself.”

Whether you find the case persuasive or not is probably beside the point, since the most salient feature of our current political landscape is that most Americans appear to have already made up their minds about he who — in the case of “Evil on Trial,” anyway — must not be named.

Mike Hale is a television critic for The Times. He also writes about online video, film and media. More about Mike Hale

Explore More in TV and Movies

Not sure what to watch next we can help..

Leslye Headland’s new “Star Wars” show, The Acolyte,” is a dream come true, but she knows it carries enormous expectations .

Once relegated to supporting roles, the comedian Michelle Buteau  is a star of the film “Babes” and is moving to a bigger stage, Radio City Music Hall, for her new special.

American audiences used to balk at subtitles. But recent hits like “Shogun” and “Everything Everywhere All at Once” show how much that has changed .

If you are overwhelmed by the endless options, don’t despair — we put together the best offerings   on Netflix , Max , Disney+ , Amazon Prime  and Hulu  to make choosing your next binge a little easier.

Sign up for our Watching newsletter  to get recommendations on the best films and TV shows to stream and watch, delivered to your inbox.

'Godzilla Minus One' Review: The Iconic Monster Smashes His Way to Netflix

Your changes have been saved

Email Is sent

Please verify your email address.

You’ve reached your account maximum for followed topics.

The Big Picture

• Godzilla Minus One takes the iconic movie monster back to his roots and offers a thrilling take on the character, unleashing his destructive force in new ways.
• The film balances sweeping spectacle and tense action with the more complicated themes of war and loss, making it a solid monster movie that hardly ever makes a wrong step.
• While the film patiently builds up the looming threat of Godzilla, every sequence with the monster hits hard and showcases the magnificent craft of the VFX artists, making it one of the best recent entries in the series.

Though not the only movie monster out there, there is perhaps no more iconic figure than Godzilla . Whether you’ve seen merely one of his many movies or all of them, the towering figure has long cast a shadow over the trajectory of cinema itself. A monster of epic scale with atomic breath that he unleashes on the world , he has had the longest reign of any being put to screen. His latest, Godzilla Minus One , sees director Takashi Yamazaki taking the King of the Monsters back to his roots and offering him the chance to smash his way to new heights. Though always a destructive force, this film is the one that sees him being unleashed in new ways. Nothing and no one is safe from his destructive force as he becomes his own all-consuming being in one of the most thrilling takes on the character in recent memory.

Godzilla Minus One

Post war Japan is at its lowest point when a new crisis emerges in the form of a giant monster, baptized in the horrific power of the atomic bomb.

This isn’t to diminish some of the other recent efforts, as both the surprisingly engaging series Monarch: Legacy of Monsters and the spectacular film Shin Godzilla have felt refreshing. In fact, Godzilla Minus One feels like it exists in the middle of the two, both in thematic interest and in quality. It is better than Monarch: Legacy of Monsters in that it doesn’t get too caught up in clunky narrative developments while not quite reaching the heights of something like Shin Godzilla . It ends up having more sweeping spectacle and tense action while also gesturing towards the more complicated themes of the latter as it grapples with the immense destruction of war. Whether you want to read it as a metaphor for immense loss or just get swept up in its thrills as a solid monster movie, G odzilla Minus One hardly ever makes a wrong step, even as these are mighty big feet it is working with . The King has truly returned.

What Is 'Godzilla Minus One' About?

First picking up in 1945 Japan at the end of World War II, this all begins with the troubled young Kōichi Shikishima ( Ryunosuke Kamiki ), who is a pilot making what he says is an emergency landing. Of course, after doing so, he discovers that there is a being on this island that soon attacks him and the soldiers there. The more dinosaur-like creature is initially quite small, at least relative to how we expect Godzilla to normally be, but the military is still no match for him as he gobbles them up. It is a bit of a shaky start , as the early design of this creature feels a little too reminiscent of elements of the disastrous 1988 American film, but it still settles in much better because of the commitment to the effects that will only grow more consistently incredible throughout the film. In this opening, everyone is killed, save for Shikishima and the lead mechanic, Sōsaku Tachibana ( Munetaka Aoki ), who must then try to rebuild their lives over the next couple of years in the aftermath of postwar Tokyo.

What is often already dire gets much worse when the United States conducts nuclear tests that mutate this being into a gargantuan Godzilla, leaving the people of Japan to come together to fight off the monster or be obliterated forever . While very much about history and the loss of war, it is grounded in people rather than being about how great the government is, as one character remarks that there is no one there who “will take responsibility for the chaos.” Though not a robust criticism by any means, as it skirts around some of the more troubling aspects of its history, it still offers up a slight dose of cynicism to chew on.

There is then an element of personal redemption at stake for Shikishima, just as there is an existential threat bearing down on all of them. He first begins working as a minesweeper with an eccentric crew that will then come face-to-boat with Godzilla. It makes for one of the most understated yet still tense sequences, as they must survive in their rather rinky-dink vessel that could easily make for a nice snack for the monster. This is merely the beginning of the outstanding visual effects that are not only impressive in terms of their spectacle but also in how they are deployed . Just seeing Godzilla swimming in pursuit of the boat is as stunning as it is sinister. It feels more like a scene from Jaws than it does an enormous monster movie. However, that makes it all the more effective as it gets more expansive with all that follows.

'Godzilla Minus One' Looks and Feels Like a Monster Movie Should

Though Godzilla Minus One isn’t afraid of showing Godzilla in all his glory, it also doesn’t go all out right away and instead patiently builds up the looming threat that he represents. The moment where they think they’ve defeated the creature, only to see how quickly it regenerates, is perfectly played as a grim stomach-drop of a moment. It’s the type of film that leans into being a hopeful crowd-pleaser, frequently in a way that undercuts its emotional moments, but the craft behind it remains magnificent. Godzilla Plus One is a film that showcases the art in the often undervalued work of VFX artists . They are as much a key to this film as anything.

Every sequence with Godzilla, while often sparing, as is a common complaint of the series that will likely arise with this one, hits hard for those patient enough for them. You feel every thundering step crashing into the ground as he makes his way through a crowded city that is struck with terrifying awe when he begins to build up his explosive power. The film isn’t quite as strong without him, feeling a bit lost in the middle and in some elements of the end, though the monster at the core is enough of the main attraction to smooth over any such flaws. When it all comes down to it and the door potentially left open for more, Godzilla Minus One more than carves out its place among the best entries of this long-running series . Whatever comes next for this refreshingly unique incarnation of the creature and his seemingly insatiable hunger for destruction, one can be glad this beautiful behemoth rose up once more.

Godzilla Minus One is among the best takes on the character not just of recent memory, but in his long reign in cinema.

• The visual effects are magnificent, showcasing the art and critical importance of the craft behind it.
• The film is as often stunning as it is sinister, starting small before getting even more effective as its more expansive.
• It's a truly thrilling experience that balances spectacle with more complicated themes of war and loss.

Godzilla Minus One is now available to stream on Netflix in the U.S.

WATCH ON NETFLIX

• Movie Reviews

• Case report
• Open access
• Published: 25 May 2024

Wandering spleen presenting in the form of right sided pelvic mass and pain in a patient with AD-PCKD: a case report and review of the literature

• Yitagesu aberra shibiru   ORCID: orcid.org/0000-0003-3645-9115 1 ,
• Sahlu wondimu 1 &
• Wassie almaw 1  

Journal of Medical Case Reports volume  18 , Article number:  259 ( 2024 ) Cite this article

355 Accesses

2 Altmetric

Metrics details

Wandering spleen is a rare clinical entity in which the spleen is hypermobile and migrate from its normal left hypochondriac position to any other abdominal or pelvic position as a result of absent or abnormal laxity of the suspensory ligaments (Puranik in Gastroenterol Rep 5:241, 2015, Evangelos in Am J Case Rep. 21, 2020) which in turn is due to either congenital laxity or precipitated by trauma, pregnancy, or connective tissue disorder (Puranik in Gastroenterol Rep 5:241, 2015, Jawad in Cureus 15, 2023). It may be asymptomatic and accidentally discovered for imaging done for other reasons or cause symptoms as a result of torsion of its pedicle and infarction or compression on adjacent viscera on its new position. It needs to be surgically treated upon discovery either by splenopexy or splectomy based on whether the spleen is mobile or not.

Case presentation

We present a case of 39 years old female Ethiopian patient who presented to us complaining constant lower abdominal pain especially on the right side associated with swelling of one year which got worse over the preceding few months of her presentation to our facility. She is primiparous with delivery by C/section and a known case of HIV infection on HAART. Physical examination revealed a right lower quadrant well defined, fairly mobile and slightly tender swelling. Hematologic investigations are unremarkable. Imaging with abdominopelvic U/S and CT-scan showed a predominantly cystic, hypo attenuating right sided pelvic mass with narrow elongated attachment to pancreatic tail and absent spleen in its normal position. CT also showed multiple different sized purely cystic lesions all over both kidneys and the pancreas compatible with AD polycystic kidney and pancreatic disease.

With a diagnosis of wandering possibly infarcted spleen, she underwent laparotomy, the finding being a fully infarcted spleen located on the right half of the upper pelvis with twisted pedicle and dense adhesions to the adjacent distal ileum and colon. Release of adhesions and splenectomy was done. Her post-operative course was uneventful.

Wandering spleen is a rare clinical condition that needs to be included in the list of differential diagnosis in patients presenting with lower abdominal and pelvic masses. As we have learnt from our case, a high index of suspicion is required to detect it early and intervene by doing splenopexy and thereby avoiding splenectomy and its related complications.

Peer Review reports

Introduction

Wandering spleen is a rare clinical entity characterized by hypermobility of the spleen as a result of absence or abnormal laxity of its suspensory ligaments which in turn can be congenital or precipitated by a number of risk factors like repeated pregnancy, trauma, surgery or connective tissue disorder. The spleen therefore migrates from its normal left hypochondriac position, to other parts of the peritoneal cavity especially the pelvis [ 3 ]. Since the first case report in 1667, there have been less than 600 cases reported in the literature so far [ 1 , 3 ].

Wandering spleen can have different clinical presentations ranging from asymptomatic incidental finding on imaging to features of acute abdomen as a result of complete torsion of the pedicle and total infarction of the spleen or complete obstruction of adjacent hollow viscus due to pressure effect. Less dramatic presentation includes chronic lower abdominal pain, swelling and symptoms of partial obstruction of bowel especially of the colon [ 3 , 4 , 5 , 6 ].

Diagnosis is confirmed by imaging usually abdominal ultrasound or CT which reveals that the spleen is absent from its normal anatomical position but seen somewhere else in the new location within the peritoneal cavity [ 3 , 9 , 10 ]. Once diagnosed, surgical intervention is required either by splenopexy or splenectomy depending on the viability of the organ [ 3 , 5 ] and can be done laparoscopically or by laparotomy.

Owing to its rarity, a high index of suspicion is required and this condition should always be considered as a possible differential diagnosis in patients presenting with lower abdominal swelling and pain. We present this case to share our experience in diagnosing and managing such a rare pathology and once again bring it to the attention of fellow clinicians handling this sort of abdominal conditions.

Case summary

Our patient is a 39 years old female Primi-para Ethiopian, who presented with lower abdominal dull aching pain of one-year duration which got worse over the last few months associated with right lower abdominal swelling, easy fatigability, LGIF, loss of appetite and weight. She is a known case of RVI on HAART for the past 18yrs and hypertensive for the last 8 years for which she was taking enalapril and atenolol. Her only child was delivered by C/section 10 years ago.

On examination , she looked chronically sick with her vitals in the normal range. The abdomen was flat with a lower midline surgical scar and a visible round mass on the right paraumblical and lower quadrant areas. The mass was well defined, smooth surfaced, slightly tender and mobile (Fig.  1 —black arrow).

Black arrow shows the splenic mass, red arrow shows the stomach, cyan arrow shows previous CS scar

Her hematologic tests revealed WBC of 8.7 × 103, Hgb of 12.3 and PLT count of 544 × 10 3 . Serum electrolyte and liver function tests were all in the normal range. Creatinine was 1.4 mg/dl.

Abdominal ultrasound

Multiple bilateral renal, liver and pancreatic cysts. An ehcocomplex mainly hypoechoic, 13 cmx8cm well defined right sided abdomino-pelvic mass, with absent color Doppler flow. Spleen was not visualized in its normal anatomic site.

Contrast enhanced abdomino-pelvic CT

Described the mass as a hypoattenuating, well circumscribed lesion with no contrast enhancement located at right abdomino pelvic cavity (Fig.  2 ). Its long torsed pedicle could be traced to the region of the tail of the pancreas and the spleen was missing from its normal location. (Fig.  3 ) Majority of the renal parenchyma is almost replaced with different sized cystic lesions with imperceptible wall causing bilateral renal enlargement. (Fig.  3 ) The liver and the pancreas too is filled with similar cysts. The portal vein were not visualized and replaced by periportal enlarged collateral vessels. (Figs.  3 , 4 ).

Infarcted spleen

Absent spleen in the splenic fossa

Spleen seen in the abdomino-pelvic cavity

With a diagnosis of wandering spleen located in the right abdomino pelvic region with torsion of the pedicle and infarction, she was admitted and underwent laparotomy. Intraoperatively, dense adhesion encountered between the anterior abdominal wall, omentum, the wandering spleen and small bowel. The spleen was whitish, distended and grossly infarcted with its long stalk torsed > 360°. (Fig.  5 ) Adhesions were gently released and splenectomy done. The splenic mass was sent for biopsy.

The intra-op picture of our patient upon exploration

She was discharged on the 3rd postoperative day and her post-operative course was uneventful. She was seen after a month on follow up clinic with no report of complication. Her biopsy result showed splenic tissue. She got her pentavelant vaccine on the third week.

Wandering spleen is a rare clinical entity characterized by splenic hypermobility from its left hypochondriac position to any other abdominal or pelvic position caused by absent or abnormal laxity of the suspensory ligaments [ 1 , 2 ].

The first case of wandering spleen was reported by Von Horne in 1667. So far less than 600 cases are reported world wide [ 1 , 3 ].

Anatomically a normal spleen is found in the left hypochondriac region suspended by ligaments to the stomach, kidney, pancreas, colon and left hemi-diaphram by the gastrosplenic, splenorenal, pancreaticosplenic, splenocolic, splenophreni ligaments and presplenic folds [ 1 ]. Our patient presented with RLQ palpable abdominal mass which is against the commonest presentation being in the LLQ of the abdomen (Fig.  1 ).

It could result from either a developmental failure of the embryonic septum transversum to fuse properly with the posterior abdominal wall which results in absent/lax ligaments [ 4 ] or from acquired conditions that result in lax suspensory ligaments as in pregnancy or connective tissue disorders [ 3 ]. The spleen is found in any quadrant of the abdomen or the pelvis though mostly in the left quadrants attached only by a long and loose vascular pedicle. Our patient presented with RLQ mass.

It is mostly seen in multiparous women [ 4 ] though the incidence is found to be nearly equal in both sexes in the prepubertal age group [ 3 ]. Our patient was a Para 1 mother and presented with 01 year history of abdominal pain which got worse in the past 06 months. Otherwise she had no any other pressure symptoms. She had visible umbilical area mass which was mobile up on examination

Wandering spleen can have different presentation ranging from asymptomatic incidental finding on imaging or upon surgical exploration for other surgical conditions to a presentation that mimics acute abdomen [ 3 , 5 ]. Mostly it presents as an on and of type acute/ subacute non-specific abdominal pain due to torsion and spontaneous de-torsion of the loose splenic pedicle [ 3 , 4 ]. This chronic torsion results in congestion and splenomegaly [ 3 , 5 ]. Hence patients could have palpable mobile mass [ 6 ] which is the typical presentation of this patient. The other presentations are usually related to the mass effect of the enlarged spleen and patients could present with GOO, bowel obstruction, pancreatitis and urinary symptoms [ 3 , 6 ].

In some cases it is reported to be associated with some other disorders like gastric volvulus [ 7 ] and distal pancreatic volvulus [ 8 ].

Ultrasound is one of the imaging modalities to investigate patients whom we suspect had wandering spleen. It usually shows absent spleen in the splenic fossa and a comma shaped spleen in the abdomen or pelvis [ 9 ]. Doppler study might help us see the vascular condition and ads up to a better preoperative plan. CT scan shows absence of the spleen in the left upper quadrant, ovoid or comma-shaped abdominal mass, enlarged spleen, a whirled appearance of non-enhancing splenic vessels and signs of splenic hypo-perfusion: homogenous or heterogeneous decreased enhancement depending on the degree of infarction [ 3 , 9 , 10 ].

Our patient was scanned with US and showed 13*8 cm large midline abdomino-pelvic well defined oval mass which was predominantly solid with areas of cystic component with absent color Doppler flow. Otherwise the spleen was not visualized in the splenic fossa. Bilateral kidney and liver has multiple different sized cystic lesions. With this image Abdomino-pelvic CT was done and shows spleen is located in the lower abdomen and appears to have torsed vascular pedicle and the whole splenic parenchyma is hypodense and no enhancement seen. Majority of the renal parenchyma is almost replaced with different sized cystic lesions with imperceptible wall causing bilateral renal enlargement. The whole liver is filled with cystic lesions with imperceptible wall. The portal veins were not visualized and replaced by periportal enlarged collateral vessels (Figs.  6 , 7 ).

Usually surgical management is the rule once a patient is diagnosed with wandering spleen [ 3 , 5 ]. Most patients; 65% as reported in some studies will have torsion of the vascular pedicle at some point of their life [ 5 , 6 ]. Hence splenopexy or splenectomy shall be considered when a wandering spleen is found incidentally up on surgical exploration for some other purposes [ 6 ]. Complicated wandering spleen like infarcted, signs of hypersplenism, huge in size and splenic vein thrombosis needs splenectomy while others can be managed with splenopexy [ 3 , 5 , 6 ]. Nowadays though laparoscopic technique is the gold standard, open technique can be used for splenopexy and splenectomy [ 3 , 5 ].

Partial infraction of a wandering spleen might necessitate partial splenectomy and splenopexy or splenectomy and splenic implantation [ 6 , 11 ].

The spleen might get fixed by different methods [ 8 , 9 ].

Simple splenic fixation involves simple tacking the splenic capsule to the peritoneum

Retroperitoneal pouch splenopexy- Tissue [ 11 , 12 ]/Mesh splenopexy (sandwich technique) [ 13 ].

Omental and peritoneal pouch splenic fixation [ 14 ].

In our case, Spleen was absent from the normal anatomic splenic fossa and the spleen in the abdomino-pelvic area looks infarcted. Hence she was managed with splenectomy and the patient was extubated on table and having a stable postoperative course .

Wandering spleen is a rare form of splenic pathology. Such a rare pathology presents commonly as an acute torsion with infarction. Spleen in the RLQ with chronic torsion and infarction is a very rare presentation for wandering spleen. In addition there is no report of such a presentation in a patient with AD-PCKD.

Recommendation

We recommend Clinicians to consider wandering spleen in their differential diagnosis in a patient presenting with RLQ abdominal mass and chronic abdominal pain.

Availability of supporting data

Data related with this case report is available at Addis ababa university, Tikur Ambesa Tertiary Hospital.

Abbreviations

Autosomal dominant polycystic kidney disease

Blood pressure

Low grade intermittent fever

High active anti-retroviral therapy

Right lower quadrant

Retro viral infection

Hypertension

White blood cell count

Puranik AK, et al . Wandering spleen: a surgical enigma. Gastroenterol Rep. 2015;5:241.

Google Scholar  

Evangelos K, et al . Wandering spleen volvulus: a case report and literature review of this diagnostic challenge. Am J Case Rep. 2020;21: e925301.

Jawad M. Wandering spleen: a rare case from the emergency department. Cureus. 2023;15(1): e33246.

PubMed   PubMed Central   Google Scholar  

Ayaz UY, et al . Wandering spleen in a child with symptoms of acute abdomen. Med Ultrasonogr. 2012;14:64.

Masroor M, Sarwari MA. Torsion of the wandering spleen as an abdominal emergency: a case report. BMC Surg. 2021;21:289.

Article   PubMed   PubMed Central   Google Scholar  

Blouhos K, et al . Ectopic spleen: an easily identifiable but commonly undiagnosed entity until manifestation of complications. Int J Surg Case Rep. 2014;8:451–4.

Article   Google Scholar  

Uc A. Gastric volvulus and wandering spleen. Am J Gastroenrterol. 1998;93:1146–8.

Article   CAS   Google Scholar  

Alqadi GO, Saxena AK. Is laparoscopic approach for wandering spleen in children an option? J Min Access Surg. 2019;15:93.

Awan M, et al . Torsion of wandering spleen treated by laparoscopic splenopexy. Int J Surgery Case Rep. 2019;62:58.

Taori K, et al . Wandering spleen with torsion of vascular pedicle: early diagnosis with multiplaner reformation technique of multislice spiral CT. Abdom Imaging. 2004;29:09428925.

Fonseca AZ, et al . Torsion of a wandering spleen treated with partial splenectomy and splenopexy. J Emerg Med. 2013;44:e33.

Article   PubMed   Google Scholar  

Seashore JH, McIntosh S. Elective splenopexy for wandering spleen. J Pediatr Surg. 1990;25:270–2.

Article   CAS   PubMed   Google Scholar  

Soleimani M. Surgical treatment of patients with wandering spleen: report of six cases with a review of the literature. Surg Today. 2007;37:261.

Peitgen K. Laparoscopic splenopexy by peritoneal and omental pouch construction for intermittent splenic torsion (“wandering spleen”). Surg Endosc. 2001;15:413.

Download references

Acknowledgements

We would like to thank the managing team of this patient including all the ward staffs who played a great role in the peri-operative management of this patient. We also appreciate the support of our consultants, residents and member of the department of surgery and HPB unit. Our kind gratitude goes to the family of this patient for their unreserved support in post-operative period that helped for the fast recovery of this patient

Funding is not applicable.

Author information

Authors and affiliations.

Addis Ababa University, Addis Ababa, Ethiopia

Yitagesu aberra shibiru, Sahlu wondimu & Wassie almaw

You can also search for this author in PubMed   Google Scholar

Contributions

Dr. Yitagesu Aberra, Main author of this case report, is an HPB surgery fellow in the department of surgery, college of health science, Addis Ababa University who was the leading surgeon in the management of this patient. Dr. Sahlu Wendimu is an HPB surgery subspecialist and Assistant professor of General Surgery who was the consultant in duty during the management of this patient. Dr.Wassie Almaw is a 2nd year pediatric surgery resident attaching at HPB surgery unit who took part in the management of this patient.

Corresponding author

Correspondence to Yitagesu aberra shibiru .

Ethics declarations

Ethics approval and consent to participate.

Ethical clearance is not applicable but we took oral and written consent from the patient for case presentation and publication.

Consent for publication

Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.

Competing interests

There is no competing interest in this case presentation.

Additional information

Publisher's note.

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ . The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/ ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and permissions

About this article

Cite this article.

shibiru, Y.a., wondimu, S. & almaw, W. Wandering spleen presenting in the form of right sided pelvic mass and pain in a patient with AD-PCKD: a case report and review of the literature. J Med Case Reports 18 , 259 (2024). https://doi.org/10.1186/s13256-024-04580-6

Download citation

Received : 02 December 2023

Accepted : 02 May 2024

Published : 25 May 2024

DOI : https://doi.org/10.1186/s13256-024-04580-6

Share this article

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

• Wandering spleen
• Splenic torsion
• Splenic infarction
• Splenectomy

Journal of Medical Case Reports

ISSN: 1752-1947

• Submission enquiries: Access here and click Contact Us
• General enquiries: [email protected]

• Cast & crew

Inside Out 2

Follow Riley, in her teenage years, encountering new emotions. Follow Riley, in her teenage years, encountering new emotions. Follow Riley, in her teenage years, encountering new emotions.

• Kelsey Mann
• Dave Holstein
• Meg LeFauve
• Amy Poehler
• Phyllis Smith
• Lewis Black

• Embarrassment

• Riley Andersen

• Mrs. Andersen

• Mr. Andersen

• Valentina 'Val' Ortiz

• Coach Roberts

• Subconscious Guard Frank

• Subconscious Guard Dave

• Forgetter Bobby

• Forgetter Paula
• All cast & crew
• Production, box office & more at IMDbPro

The Big List of Summer Movies

More like this

Did you know

• Trivia The first trailer received 157 million online views within the first 24 hours, more than any other Disney animated film, surpassing Frozen II (2019) , with 116 million views.

Riley Anderson : [from the trailer] I'M THE WORST!

Mom's Anger : Welp, there's a preview of the next ten years.

• Connections Featured in AniMat's Crazy Cartoon Cast: The D23 Expo 2022 Special (2022)
• When will Inside Out 2 be released? Powered by Alexa
• June 14, 2024 (United States)
• United States
• Instagram - Disney's Announcement
• Instagram - Pixar's Announcement
• Những Mảnh Ghép Cảm Xúc 2
• Walt Disney Feature Animation - 500 S. Buena Vista Street, Burbank, California, USA (Studio)
• Walt Disney Pictures
• Pixar Animation Studios
• See more company credits at IMDbPro

Technical specs

• Runtime 1 hour 40 minutes
• Dolby Digital
• Dolby Atmos
• 12-Track Digital Sound
• D-Cinema 96kHz Dolby Surround 7.1
• D-Cinema 96kHz 7.1

Related news

Contribute to this page.

• See more gaps
• Learn more about contributing

More to explore

Recently viewed.