2025 Volume 61 Issue 6 Pages 954-961
Accessory spleens are found in 10–30% of autopsy cases and are generally asymptomatic. However, in rare instances, torsion and subsequent infarction may result in acute abdominal symptoms. We present a case of a 13-year-old male who was admitted with abdominal pain and underwent laparoscopically assisted resection of an intra-abdominal mass. Preoperative imaging demonstrated a well-demarcated lesion with low signal intensity on T1-weighted MRI and high signal intensity on T2-weighted imaging. Histopathological findings confirmed splenic tissue with trabecular structures and an artery with organized thrombus, leading to a definitive diagnosis of accessory spleen torsion. The postoperative course was uneventful, with no evidence of recurrence or complications during follow-up. The preoperative diagnosis of accessory spleen torsion is challenging owing to its nonspecific presentation. However, when clinically suspected, diagnostic laparoscopy should be considered for both diagnosis and treatment. This case may aid in improving the recognition and management of this rare condition.
