A Case of Accessory Spleen Torsion Diagnosed Preoperatively and Treated by Laparoscopic Resection

Abstract

A 12-year-old boy was referred to our hospital owing to left abdominal pain that lasted for two days after trauma. Contrast CT showed a 4-cm-diameter mass localized in an area inferior to the left kidney. He was admitted to our hospital with suspicion of left abdominal tumor. Ultrasonography revealed that the blood flow in the mass vanished, and enhanced MRI demonstrated a twisted cord from the mass with hemorrhagic infarction toward the splenic hilum. Therefore, he was diagnosed as having accessory spleen torsion, and laparoscopic resection was performed on the 19th day after his injury. Histopathological findings showed that the accessory spleen infarction occurred owing to pedicle torsion. Accessory spleen is very rare and the preoperative diagnosis was difficult owing to specific findings in images. From our experience, the detection of pedicle torsion is important for the preoperative diagnosis.