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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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2
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Smoot T, Revels J, Soliman M, Liu P, Menias CO, Hussain HH, Savas H, Gaballah AH. Abdominal and pelvic splenosis: atypical findings, pitfalls, and mimics. Abdom Radiol (NY) 2022; 47:923-947. [PMID: 35076742 DOI: 10.1007/s00261-021-03402-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 12/22/2021] [Accepted: 12/24/2021] [Indexed: 01/28/2023]
Abstract
Splenosis is an acquired form of ectopic splenic tissue that typically arises after trauma or splenectomy. It is often an incidental image finding in an otherwise asymptomatic patient, but the spectrum of symptoms varies based on the site of implantation. Radiologists should be familiar with the imaging features of splenosis to avoid mistaking it for malignancy. Splenosis has identical imaging features to that of the native spleen on US, CT, MRI, and nuclear medicine examinations. Therefore, when the radiologic findings support the diagnosis of splenosis, the patient can be spared invasive procedures for tissue sampling.
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Affiliation(s)
- Travis Smoot
- Department of Diagnostic Radiology, University of Missouri, One Hospital Dr. Columbia, Columbia, MO, 65212, USA
| | - Jonathan Revels
- Department of Radiology, University of New Mexico, Albuquerque, NM, USA
| | - Moataz Soliman
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL, 48109, USA
| | - Peter Liu
- Department of Radiology, Cleveland Clinic, Cleveland, OH, USA
| | | | - Hero H Hussain
- Department of Radiology, University of Michigan, Ann Arbor, MI, USA
| | - Hatice Savas
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL, 48109, USA
| | - Ayman H Gaballah
- Department of Diagnostic Radiology, University of Missouri, One Hospital Dr. Columbia, Columbia, MO, 65212, USA.
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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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El-Helou E, Alimoradi M, Sabra H, Ghoussoub Y, Zaarour M, Abousleiman G. Small bowel obstruction due to splenosis 30 years after splenectomy. Ann R Coll Surg Engl 2020; 102:e1-e3. [PMID: 32508109 DOI: 10.1308/rcsann.2020.0131] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Splenosis is the autotransplantation of splenic tissue into abnormal locations due to trauma or iatrogenically. Usually, this causes no symptoms, but in rare cases the mass effect of the transplanted nodules can cause small bowel obstruction. Resection of the culprit splenic tissue is recommended, but not more extensive dissection of non-involved nodules. Our patient presented at 43 years of age with abdominal pain, distention and bilious vomiting. He had undergone a splenectomy at the age of 13 years due to splenic rupture after a motor vehicle collision. Computed tomography demonstrated a small bowel obstruction with multiple nodules suspicious of splenosis. The obstructing mass and compromised bowels. were resected. Final pathology confirmed the diagnosis. Splenosis is an uncommon aetiology of small bowel obstruction and must be considered in patients who had previous splenic trauma or surgery.
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Affiliation(s)
- E El-Helou
- Lebanese University, Faculty of Medical Sciences, Mount Lebanon, Lebanon
| | - M Alimoradi
- Lebanese University, Faculty of Medical Sciences, Mount Lebanon, Lebanon
| | - H Sabra
- Lebanese University, Faculty of Medical Sciences, Mount Lebanon, Lebanon
| | - Y Ghoussoub
- Lebanese University, Faculty of Medical Sciences, Mount Lebanon, Lebanon
| | - Mariana Zaarour
- Lebanese University, Faculty of Medical Sciences, Mount Lebanon, Lebanon
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El-Kheir A, Abdelnour M, Boutros JG. Simultaneous small bowel and colon obstruction due to splenosis. A case report and review of literature. Int J Surg Case Rep 2019; 58:63-66. [PMID: 31009896 PMCID: PMC6479103 DOI: 10.1016/j.ijscr.2019.03.040] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 03/19/2019] [Accepted: 03/22/2019] [Indexed: 12/14/2022] Open
Abstract
Splenosis is an autotransplantation of splenic tissues throughout the body post splenic rupture or splenectomy. Symptomatic when hematological diseases have recurred. Abdominal splenosis may rarely be associated with abdominal pain and/or gastrointestinal symptoms. Further evaluation and treatment is mandatory when bowel obstruction is present. Treatment consists of resection of problematic splenic nodules.
Introduction Splenosis, an autotransplantation of splenic tissues in another compartment of the body, is only symptomatic when hematologic diseases have recurred or compression of other adjacent structures have occurred. Therefore, we report a clinical case of a patient with bowel obstruction due to splenosis. Case presentation A patient with a history of splenectomy, presented to the emergency room for abdominal pain and obstipation, suggesting intestinal obstruction which is also seen on CT scan. During laparotomy, multiple splenic nodules were seen on the mesentery of the small bowel and colon, with vascular bridges between them, resulting in bowel obstruction. Resection of splenic nodules was performed. The post-operative course was uneventful and the patient was discharged a week after. Discussion Although very rare, gastrointestinal symptoms may sometimes be described in patients with splenosis. Bleeding or obstruction can occur because of intramural grow or external compression, respectively. Treatment consists of resection of these nodules. Conclusion Splenosis should always be thought in patients with previous splenic rupture and presenting with incidental nodules seen on imaging, with further investigations when symptoms are present.
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Affiliation(s)
- Alaa El-Kheir
- Department of General and Digestive Surgery, Nini Hospital, Tripoli, Lebanon.
| | - M Abdelnour
- Department of Gastroenterology and Hepatology, Maritime Hospital, Jbeil, Lebanon
| | - Jihad G Boutros
- Department of General and Digestive Surgery, Maritime Hospital, Jbeil, Lebanon
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Abstract
Splenosis is a benign condition that can occur after splenic trauma or after surgery involving the spleen. These splenic implants are most often seen within the abdominal and pelvic cavities. On imaging, splenosis can be confused with multiple additional entities including metastatic disease, peritoneal carcinomatosis, peritoneal mesothelioma, abdominal lymphoma, renal cancer, hepatic adenomas, or endometriosis depending on its distribution. In all patients with history of splenic surgery or trauma, splenosis should be on the differential diagnosis of soft tissue nodules in the abdomen and pelvis, especially in the absence of systemic symptoms, to avoid unnecessary biopsy, chemotherapy, or surgery.
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Affiliation(s)
- Yasmeen K Tandon
- Section of Abdominal Imaging, Imaging Institute, Cleveland Clinic, 9500 Euclid Ave., Cleveland, OH, 44195, USA.
| | - Christopher P Coppa
- Section of Abdominal Imaging, Imaging Institute, Cleveland Clinic, 9500 Euclid Ave., Cleveland, OH, 44195, USA
| | - Andrei S Purysko
- Section of Abdominal Imaging, Imaging Institute, Cleveland Clinic, 9500 Euclid Ave., Cleveland, OH, 44195, USA
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Arena R, Gasperoni S, Lisotti A, Petrini CAA, Brancaccio ML, Triossi O, Mussetto A. An unusual cause of gastrointestinal bleeding and intestinal obstruction. TURKISH JOURNAL OF GASTROENTEROLOGY 2018; 29:365-366. [PMID: 29755023 DOI: 10.5152/tjg.2018.17647] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Rosario Arena
- Division of Gastroenterology, S. Maria delle Croci Hospital, Ravenna, Italy
| | - Stefano Gasperoni
- Division of Gastroenterology, S. Maria delle Croci Hospital, Ravenna, Italy
| | - Andrea Lisotti
- Gastrointestinal Unit, Bologna University Hospital of Imola, Bologna, Italy
| | - Chiara A A Petrini
- Division of Gastroenterology, S. Maria delle Croci Hospital, Ravenna, Italy
| | - Mario L Brancaccio
- Division of Gastroenterology, S. Maria delle Croci Hospital, Ravenna, Italy
| | - Omero Triossi
- Division of Gastroenterology, S. Maria delle Croci Hospital, Ravenna, Italy
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Vergara D, Ginolfi F, Moscati S, Giordano B, Ferrara N, Panico C, Imbriaco M. Multiple intra-hepatic and abdominal splenosis: an easy call if you know about it. Acta Radiol Open 2018; 7:2058460118772324. [PMID: 29780616 PMCID: PMC5952290 DOI: 10.1177/2058460118772324] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 03/28/2018] [Indexed: 12/14/2022] Open
Abstract
Hepatic splenosis represents the heterotopic implantation of splenic tissue caused by the spillage of cells from the spleen usually after splenectomy or splenic trauma. This condition is usually an incidental finding during surgery and its real incidence is unknown. Splenic implants, which can be placed anywhere in the abdominal cavity, are usually multiple and may be confused with different benign and malignant conditions such as renal tumors, abdominal lymphomas, and endometriosis. We hereby report an unusual case of multiple abdominal splenosis, with a particular intra-hepatic location, that could be misinterpreted as an hepato-cellular carcinoma.
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Affiliation(s)
- Doriana Vergara
- Department of Advanced Biomedical Sciences, University Federico II, Naples Italy
| | - Francesco Ginolfi
- Department of Advanced Biomedical Sciences, University Federico II, Naples Italy
| | - Stefano Moscati
- Department of Advanced Biomedical Sciences, University Federico II, Naples Italy
| | - Beniamino Giordano
- Department of Translational Medical Sciences, Division of Geriatrics, University Federico II, Naples Italy
| | - Nicola Ferrara
- Department of Translational Medical Sciences, Division of Geriatrics, University Federico II, Naples Italy
| | - Camilla Panico
- Department of Advanced Biomedical Sciences, University Federico II, Naples Italy
| | - Massimo Imbriaco
- Department of Advanced Biomedical Sciences, University Federico II, Naples Italy
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