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Chapagain A, Yadav GK, Bhandari S, Devkota K, Adhikari B, Singh A, Bhattarai R. Multiple intra-abdominal splenosis with imaging correlative findings: A case report and review of literature. Radiol Case Rep 2024; 19:4312-4315. [PMID: 39161561 PMCID: PMC11331708 DOI: 10.1016/j.radcr.2024.06.084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Accepted: 06/30/2024] [Indexed: 08/21/2024] Open
Abstract
We present a case of a 31-year-old male who presented to the emergency department with a history of abdominal pain localized to the lower abdomen. The patient had undergone splenectomy 2 years ago for splenic injury following a road traffic accident. Computerized tomography showed multiple well-defined, homogeneously enhancing soft tissue density nodules of varying sizes distributed throughout the abdomen and pelvis. A diagnosis of splenosis was made based on imaging findings and history. Abdominal splenosis is an uncommon entity of which radiologists need to be aware, and this case serves to shed further light on this condition.
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Affiliation(s)
- Ashok Chapagain
- Department of Radiodiagnosis and Imaging, BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - Gopal K. Yadav
- Department of Radiodiagnosis and Imaging, BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - Sandeep Bhandari
- Department of Radiodiagnosis and Imaging, BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - Karun Devkota
- Department of Radiodiagnosis and Imaging, BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - Bijay Adhikari
- Department of Radiodiagnosis and Imaging, BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - Ashish Singh
- Department of Radiodiagnosis and Imaging, BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - Raksha Bhattarai
- Department of Radiodiagnosis and Imaging, BP Koirala Institute of Health Sciences, Dharan, Nepal
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2
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Orminski K, Monnett SW, Richmond BK. Small Bowel Obstruction due to Splenosis Mimicking Periduodenal Mass. Am Surg 2023; 89:1127-1128. [PMID: 33342247 DOI: 10.1177/0003134820971587] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Krysta Orminski
- West Virginia University School of Medicine/Charleston Campus, WV, USA
| | - Shane W Monnett
- Department of Surgery, West Virginia University School of Medicine/Charleston Division, WV, USA
| | - Bryan K Richmond
- Department of Surgery, West Virginia University School of Medicine/Charleston Division, WV, USA
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3
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Jiang Y, Chen L, Wang M, Li X, Xie D, Yu D, Wang Y. Pelvic mass causing hematospermia: splenosis. BMC Urol 2022; 22:187. [PMID: 36384575 PMCID: PMC9670433 DOI: 10.1186/s12894-022-01138-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Accepted: 10/29/2022] [Indexed: 11/17/2022] Open
Abstract
Background Most patients with splenosis have no clinical symptoms and do not need intervention. Hematospermia and testicular pain occurred in this patient, which was considered to be related to the huge pelvic implantation of the spleen, which was relatively rare in clinical practice, so we hereby report this case. Case presentation A 28-year-old male patient with a history of splenectomy was admitted to the Urology Department of the Second Affiliated Hospital of Anhui Medical University with the chief complaint of "Hematospermia for 1 month and testicular pain for 2 days". Preoperative imaging examination indicated pelvic mass. Combined with the patient's history of splenectomy for splenic rupture in childhood, the possibility of pelvic spleen implantation was considered. Laparoscopic pelvic exploration was performed. During the operation, multiple grayish-brown nodular tissues were observed in the space between the posterior bladder and rectum, and a lobulated grayish-brown mass with a diameter of about 9 cm was observed in the posterior upper part of the prostate gland and seminal vesicle at the pelvic floor. Two nodular tissues were removed intraoperatively and sent for quick frozen pathology, which was reported as spleen tissue. Further resection of the huge mass was performed, and the postoperative pathological results were consistent with the diagnosis of splenosis. Conclusion We report a rare case of splenosis presenting with hemospermia and testicular pain.
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Tang X, Gu P, Lu W. A rare case of adult colocolic intussusception secondary to splenosis. J Int Med Res 2022; 50:3000605221115386. [PMID: 36036154 PMCID: PMC9527533 DOI: 10.1177/03000605221115386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Intussusception is the invagination of a segment of bowel
(intussusceptum) into the lumen of an adjacent segment
(intussuscipiens). Adult intussusception is rare and typically
asymptomatic, although bowel obstruction can be a predominant symptom,
making it difficult to diagnose. Splenosis is an uncommon and benign
disease, arising from the self-implantation of splenic tissue
elsewhere in the body after splenectomy or splenic trauma. Colocolic
intussusception secondary to splenosis is rare. We report a case of
colon intussusception with a mass in the intussusception detected by
ultrasound. Abdominal ultrasound identified the intussusception
location but failed to distinguish its pathological properties.
Colonoscopy revealed the exudation of necrotic and fibrous tissue.
Surgery was performed because of suspicions of a malignant tumor.
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Affiliation(s)
- Xuemei Tang
- Department of Ultrasound, Sichuan Key Laboratory of Medical Imaging, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, People's Republic of China
| | - Peng Gu
- Department of Ultrasound, Sichuan Key Laboratory of Medical Imaging, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, People's Republic of China
| | - Wenming Lu
- Department of Ultrasound, Huzhou First People's Hospital, Huzhou 313000, People's Republic of China
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Belvis Jiménez M, Aparcero López R, Caunedo Álvarez Á. Abdominal splenosis: a rare entity with a possible non-invasive diagnosis. REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS 2021; 112:739-740. [PMID: 32755145 DOI: 10.17235/reed.2020.6856/2020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Splenosis is an uncommon pathology whose diagnosis requires a high index of suspicion. In most cases they are incidental findings, so their suspicion is essential to carry out a non-invasive diagnosis. We present a case of intraabadominal splenosis and perform a brief review of the literature.
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Alberto RG, Eliana LZ, Mauricio TM, Eduardo GH. Cecal splenosis mimicking gastrointestinal stroma tumor. Case report and review of the literature. Int J Surg Case Rep 2021; 83:105992. [PMID: 34062360 PMCID: PMC8178097 DOI: 10.1016/j.ijscr.2021.105992] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 05/15/2021] [Accepted: 05/16/2021] [Indexed: 01/31/2023] Open
Abstract
Introduction Abdominal splenosis is a rare condition where autotransplanted ectopic spleen tissue is found in the abdominal cavity after spleen injury or splenectomy. While abdominal splenosis is mostly described as asymptomatic, bowel splenosis can present with abdominal pain, obstipation or gastrointestinal (GI) bleeding. Scarce information on bowel splenosis exists and high index of suspicion is needed for diagnosis. We present the case of a patient with abdominal pain and a cecal mass mimicking gastrointestinal stroma tumor (GIST) found to have bowel splenosis after laparoscopic resection. Presentation of case A 45-year-old female was evaluated for a 6-month history of abdominal pain in right-lower quadrant. She had past medical history of blunt abdominal trauma and splenectomy 35 years before symptoms. An abdominal contrast-enhanced computed tomography (CT) reported a 4.2 × 4.6 × 4.6 cm solid mass located in the antimesenteric border of the cecum, with calcifications and arterial enhancement. Colonoscopy found no epithelial lesions. A diagnostic laparoscopy was done, and resection of the mass achieved. Transoperative histopathological diagnosis revealed ectopic spleen tissue. Discussion It is difficult to know whether abdominal pain in bowel splenosis is actually triggered by splenosis itself or by an unrelated cause, making diagnosis incidental. There are no particular imaging findings suggestive of splenosis, and surgical resection is often done under uncertain diagnosis. Conclusion Bowel splenosis could present as abdominal pain variable time after spleen injury or splenectomy. Clinical features and imaging characteristics are nonspecific and similar to those of GIST. Most cases of splenosis are diagnosed after surgery. Bowel splenosis is a rare entity scarcely reported in the literature. 2nd case with more years from risk factor reported. We expose a review of the literature analyzing common findings.
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Affiliation(s)
- Riojas-Garza Alberto
- Escuela de Medicina y Ciencias de la Salud del Tecnológico de Monterrey, Nuevo León, México.
| | - López-Zamora Eliana
- Escuela de Medicina y Ciencias de la Salud del Tecnológico de Monterrey, Nuevo León, México
| | | | - Guzmán-Huerta Eduardo
- Escuela de Medicina y Ciencias de la Salud del Tecnológico de Monterrey, Nuevo León, México.
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Nadeem M, Tiwari HA, Jambhekar K, Shah H, Ram R. Revisiting the Spleen—An Imaging Review of the Common and Uncommon Splenic Pathology. JOURNAL OF GASTROINTESTINAL AND ABDOMINAL RADIOLOGY 2021. [DOI: 10.1055/s-0040-1721626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
AbstractThe spleen is the largest lymphatic organ and is responsible for both hematological and immunological functions. Several common etiologies such as trauma, developmental variants, infectious/inflammatory conditions, and benign and malignant lesions can occur in the spleen. The role of imaging modalities such as ultrasound (US), computed tomography (CT), and magnetic resonance imaging (MRI) in diagnosing these conditions continues to evolve. The main objective of this review article is to illustrate the role of imaging in identifying the common and uncommon pathology of the spleen.
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Affiliation(s)
- Meshaal Nadeem
- Department of Diagnostic Radiology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, United States
| | - Hina Arif Tiwari
- Division of Radiology, Department of Medical Imaging, University of Arizona Health sciences, Tuscon, Arizona, United States
| | - Kedar Jambhekar
- Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, United States
| | - Hemendra Shah
- Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, United States
| | - Roopa Ram
- Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, United States
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8
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Intussusception due to intramural jejunal splenosis. Pediatr Radiol 2021; 51:144-147. [PMID: 32666263 DOI: 10.1007/s00247-020-04731-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Revised: 04/21/2020] [Accepted: 05/20/2020] [Indexed: 10/23/2022]
Abstract
Splenosis is defined as the growth of ectopic splenic tissue, due to its direct seeding, usually seen after traumatic or surgical procedures to the spleen. It often occurs on highly vascularized surfaces such as the omentum or the mesentery, and grows in sessile form, supplied by adjacent vessels. Intestinal splenosis with endoluminal extension is extremely rare. We present a case of intestinal splenosis with endoluminal growth in a 14-year-old boy that provoked a small bowel intussusception requiring surgical resolution.
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Chorbińska J, Krajewski W, Sroczyński M, Guziński M, Zdrojowy R. Splenosis mimicking lymphadenopathy. J Surg Case Rep 2020; 2020:rjaa425. [PMID: 33149888 PMCID: PMC7593108 DOI: 10.1093/jscr/rjaa425] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 09/10/2020] [Accepted: 09/23/2020] [Indexed: 01/20/2023] Open
Abstract
Splenosis is an autotransplantation of splenic tissue following traumatic rupture of the spleen or splenectomy. Generally, splenosis is asymptomatic. Therefore, most cases are incidental findings made during surgery, autopsy or after imaging studies for other purposes. Splenosis is a benign phenomenon, but it often shows similarity to the metastatic process. We present a case of asymptomatic intraperitoneal splenosis occurring in a 57-year-old male, in whom computed tomography urography showed lymphadenopathy suggesting a neoplastic process. A reconnaissance laparotomy was performed, and specimens were taken and sent for histopathological examination. The microscopic image of all the collected lesions corresponded to the normal spleen tissue. Due to an increasing number of traffic accidents, it is worth taking abdominal splenosis into consideration in the differential diagnosis of tumor-like changes, especially in patients with a history of splenic trauma or spleen removal. As a result, unnecessary surgery can be avoided in many cases.
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Affiliation(s)
- Joanna Chorbińska
- Department of Urology and Oncologic Urology, Wroclaw Medical University, Wrocław, Poland
| | - Wojciech Krajewski
- Department of Urology and Oncologic Urology, Wroclaw Medical University, Wrocław, Poland
| | - Maciej Sroczyński
- Department of Radiology, Wroclaw Medical University, Wrocław, Poland
| | - Maciej Guziński
- Department of General, Minimally Invasive and Endocrine Surgery, Wroclaw Medical University, Wrocław, Poland
| | - Romuald Zdrojowy
- Department of Urology and Oncologic Urology, Wroclaw Medical University, Wrocław, Poland
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Ananthan K, Yusuf GT, Kumar M. Intrahepatic and intra-abdominal splenosis: A case report and review of literature. World J Hepatol 2019; 11:773-779. [PMID: 31966909 PMCID: PMC6960294 DOI: 10.4254/wjh.v11.i12.773] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 11/11/2019] [Accepted: 11/26/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Splenosis is defined as the process by which tissue from the spleen disseminates through the body and grows in an ectopic location following trauma or a splenectomy. Visceral sites of splenosis are rare.
CASE SUMMARY We report a case of intrahepatic splenosis in a 57-year-old man with a history of trauma over 40 years ago who initially presented with chest pain. Findings initially mimicked malignancy but a diagnosis of intrahepatic splenosis was confirmed using computed tomography and scintigraphy with technetium-99m heat-denatured red blood cells (Tc-99 DRBC).
CONCLUSION Scintigraphy with Tc-99 DRBC is a reliable technique to diagnose splenosis and should be performed before using more invasive procedures are carried out. Splenosis should be considered as a possible differential diagnosis for a hepatic nodule in any patient with a history of abdominal trauma, previous splenectomy or atypical radiological features on imaging.
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Affiliation(s)
- Kiruthika Ananthan
- GKT School of Medical Education, King’s College London, London WC2R 2LS, United Kingdom
| | - Gibran Timothy Yusuf
- Department of Radiology, Princess Royal University Hospital, King’s College Hospital NHS Foundation Trust, Kent BR6 8ND, United Kingdom
| | - Mayur Kumar
- Department of Gastroenterology, Princess Royal University Hospital, King’s College Hospital NHS Foundation Trust, Kent BR6 8ND, United Kingdom
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11
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Kosydar SR, Sanchirico PJ, Pfeiffer DC. A case of thoracoabdominal splenosis. Radiol Case Rep 2019; 15:7-10. [PMID: 31737138 PMCID: PMC6849435 DOI: 10.1016/j.radcr.2019.10.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 10/10/2019] [Accepted: 10/11/2019] [Indexed: 01/10/2023] Open
Abstract
We describe a case of a 38-year-old male with a remote history of motor vehicle trauma who presented to the emergency department with 1-week history of progressively worsening abdominal pain localized to the epigastric region. Patient history included splenectomy. Computerized tomography demonstrated multiple masses in the left pleural space as well as masses continuous with the diaphragm and abdominal wall in the left upper quadrant. In addition, a lobulated mass was identified in the right upper quadrant along the anterior right hepatic lobe. A diaphragmatic defect was noted containing splenic tissue. A diagnosis of splenosis was made. Disseminated splenosis presenting in both the thorax and abdomen is rare and poorly documented. This case serves to further illuminate this condition.
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Affiliation(s)
- Samuel R Kosydar
- WWAMI Medical Education Program (MD), University of Washington School of Medicine, 1959 NE Pacific St, Seattle, WA 98195, USA
| | - Paul J Sanchirico
- St Joseph Regional Medical Center, 415 6th St, Lewiston, ID 83501, USA
| | - David C Pfeiffer
- WWAMI Medical Education Program and Department of Biological Sciences, University of Idaho, 875 Perimeter Drive, Moscow, ID 83844-3051, USA
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