A Pediatric Case of Accessory Spleen Torsion

Abstract

An accessory spleen is found in 10–30% of necropsies, but is usually asymptomatic and rarely involves torsion. We experienced treating a pediatric case of accessory spleen torsion. A 7-year-old boy was admitted owing to left upper abdominal pain. Abdominal ultrasonography revealed a solid mass in the left upper quadrant. Enhanced computed tomography showed a poorly enhanced mass. Magnetic resonance imaging revealed that the mass was hypointense on T1-weighted images and isointense on T2-weighted images. With the preoperative diagnosis of abdominal tumor, we performed open surgery. The operation showed a solid tumor of 6.0 × 7.0 cm size and had a twisted pedicle. Histopathological examinations showed that the mass contained splenic tissue with hemorrhagic necrosis. The final diagnosis was torsion of an accessory spleen with infarction. It might be difficult to make a definitive diagnosis of accessory spleen torsion preoperatively.