[Torsion of the accessory spleen: an atypical etiology for acute abdomen]

Multiple pelvic accessory spleen: Rare case report with review of literature

Accessory spleen (AS) usually presents as an isolated asymptomatic mass of splenic tissue separated from the body of the actual spleen. Multiple pelvic ASs are more unusual than single pelvic AS. The present study reported on the rare case of multiple pelvic AS. A 39-year-old Chinese woman presented at our hospital with complaints of abdominal pain for one week. A large pelvic mass behind the uterus was identified on ultrasound examination. Multiple AS in the pelvis was primarily considered during the operation and confirmed by histopathological examination after the surgery. The literature in English language was also reviewed by retrieving studies on AS published over the past 30 years, and it was discussed how to diagnose and treat pelvic AS. In conclusion, to the best of our knowledge, the present study provided the first case report of multiple pelvic AS. The gynecologist should be aware of the rare possibility of an AS in patients with abdominal and pelvic complaints and/or a pelvic mass. Pelvic AS is generally determined during radiological investigations or during open or laparoscopic surgeries.

Torsion of a huge accessory spleen in a 20-year-old patient

INTRODUCTION

Accessory spleen is a rare condition. Torsion of accessory spleen can lead to acute abdomen.

PRESENTATION OF CASE

We describe a young woman with an acute abdomen caused by torsion of accessory spleen. Abdominal computed tomography angiography (CTA) demonstrated an ischemic giant accessory spleen with a twisted vascular pedicle. An emergency laparotomy was performed with resection of the infarcted accessory spleen.

DISCUSSION

Accessory spleen is a rare and asymptomatic condition. Torsion of accessory spleen is also uncommon. Abdominal pain is the main symptom. CTA is effective in reaching a diagnosis. Definitive treatment of an acute abdomen due to accessory splenic torsion is emergency accessory splenectomy.

CONCLUSION

Elective accessory splenectomy should be recommended for known giant accessory spleen to prevent complications in future.