2021 Volume 41 Issue 5 Pages 379-382
An accessory spleen is found in 10％-30％ of the population and in most cases, it is asymptomatic. We report a rare case of infarction of an accessory spleen, which was diagnosed preoperatively and resected laparoscopically. A 35-year-old man was transported to our hospital by ambulance with the complaint of acute left-sided abdominal pain. A plain CT showed a spherical mass measuring 31mm in diameter, with a slight increase of the fat surrounding the spleen on the cranio-ventral side, and another spherical mass measuring 18mm in diameter at the splenic hilum. On contrast-enhanced CT, while the former mass was non-enhancing, the latter showed marked enhancement. US showed the feeding vessel to the mass on the cranio-ventral side of the spleen, but without blood flow. Therefore, the patient was diagnosed as having infarction of an accessory spleen caused by torsion, and laparoscopic resection was performed. We found a dark red accessory spleen in the greater omentum. The greater omentum was adherent to the vascular pedicle of the accessory spleen, so that we could not confirm the torsion. After resecting the vascular pedicle using a coagulation-cutting device, we removed the accessory spleen. Histopathological examination revealed splenic tissue with severe bleeding and congestion. The postoperative course was uneventful and the patient was discharged on postoperative day 4.
